Provider Demographics
NPI:1437743143
Name:KATHARINE BOTELLE WOLHART PLLC
Entity Type:Organization
Organization Name:KATHARINE BOTELLE WOLHART PLLC
Other - Org Name:KATHARINE BOTELLE WOLHART PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHILD & FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:BOTELLE
Authorized Official - Last Name:WOLHART
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:360-926-5647
Mailing Address - Street 1:26910 92ND AVE NW STE C5-203
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-5437
Mailing Address - Country:US
Mailing Address - Phone:360-926-5647
Mailing Address - Fax:
Practice Address - Street 1:410 W. BAKERVIEW RD. SUITE 110, OFFICE 110
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-4725
Practice Address - Country:US
Practice Address - Phone:360-926-5647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty