Provider Demographics
NPI:1477174621
Name:POYNTON, KATHERINE JANE
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:JANE
Last Name:POYNTON
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 1:628 CLARENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1702
Mailing Address - Country:US
Mailing Address - Phone:206-390-9965
Mailing Address - Fax:
Practice Address - Street 1:628 CLARENCE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-1702
Practice Address - Country:US
Practice Address - Phone:206-390-9965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA518383E103TS0200X
NY4032342103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool