Provider Demographics
NPI:1407535529
Name:WECHER, KATHLEEN A
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:WECHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:CO
Mailing Address - Zip Code:80654-7917
Mailing Address - Country:US
Mailing Address - Phone:970-370-4786
Mailing Address - Fax:
Practice Address - Street 1:203 11TH AVE
Practice Address - Street 2:
Practice Address - City:WIGGINS
Practice Address - State:CO
Practice Address - Zip Code:80654-7917
Practice Address - Country:US
Practice Address - Phone:970-370-4786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099294341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical