Provider Demographics
NPI:1689452930
Name:LAIDIG, KATI
Entity Type:Individual
Prefix:
First Name:KATI
Middle Name:
Last Name:LAIDIG
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 1:70 MUSIC SQ W APT 110
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5269
Mailing Address - Country:US
Mailing Address - Phone:608-921-3264
Mailing Address - Fax:
Practice Address - Street 1:70 MUSIC SQ W APT 110
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-5269
Practice Address - Country:US
Practice Address - Phone:608-921-3264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN87171041C0700X
WI11206-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical