Provider Demographics
NPI:1508239773
Name:PATTERSON, KATHRINE LYN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHRINE
Middle Name:LYN
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N MAYFAIR RD STE 600
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1428
Mailing Address - Country:US
Mailing Address - Phone:414-727-4455
Mailing Address - Fax:414-727-4690
Practice Address - Street 1:2500 N MAYFAIR RD STE 600
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1428
Practice Address - Country:US
Practice Address - Phone:414-727-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6402-125101YP2500X
WI3813-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional