Provider Demographics
NPI:1538514575
Name:PARAS, KATHERINE (LPAT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:PARAS
Suffix:
Gender:F
Credentials:LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5203 JUAN TABO BLVD NE
Mailing Address - Street 2:2A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2683
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5203 JUAN TABO BLVD NE
Practice Address - Street 2:2A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2683
Practice Address - Country:US
Practice Address - Phone:505-266-6121
Practice Address - Fax:505-221-5710
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health