Provider Demographics
NPI:1477105948
Name:STRONG, KATIE LEANNA
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LEANNA
Last Name:STRONG
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 1:67 IRISH SETTLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-5823
Mailing Address - Country:US
Mailing Address - Phone:518-645-4978
Mailing Address - Fax:
Practice Address - Street 1:67 IRISH SETTLEMENT RD
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-5823
Practice Address - Country:US
Practice Address - Phone:518-645-4978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY750432163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health