Provider Demographics
NPI:1407214968
Name:DARNELL, KATHRYN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:DARNELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 S 19TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6810
Mailing Address - Country:US
Mailing Address - Phone:406-580-3534
Mailing Address - Fax:
Practice Address - Street 1:502 S 19TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6810
Practice Address - Country:US
Practice Address - Phone:406-580-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-29
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2509103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty