Provider Demographics
NPI:1477072999
Name:PRIEBE, KATHERINE ROSE (PSYD, PC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ROSE
Last Name:PRIEBE
Suffix:
Gender:F
Credentials:PSYD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 HANLEY RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-8705
Mailing Address - Country:US
Mailing Address - Phone:651-214-4381
Mailing Address - Fax:
Practice Address - Street 1:2501 HANLEY RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8705
Practice Address - Country:US
Practice Address - Phone:651-214-4381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3594101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health