Provider Demographics
NPI:1598415887
Name:PRISK, KATE LEIGH-ANN
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:LEIGH-ANN
Last Name:PRISK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KATE
Other - Middle Name:LEIGH-ANN
Other - Last Name:LAFOLLETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1961 NORTHPOINT BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4999
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2826 AMNICOLA HWY
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37406-3605
Practice Address - Country:US
Practice Address - Phone:423-599-5892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician