Provider Demographics
NPI:1710268933
Name:DICAMILLO, KATHERINE
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:DICAMILLO
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 1:8863 COLORADO BLVD
Mailing Address - Street 2:APT J 306
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-8435
Mailing Address - Country:US
Mailing Address - Phone:805-901-8239
Mailing Address - Fax:
Practice Address - Street 1:8931 HURON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-6806
Practice Address - Country:US
Practice Address - Phone:303-853-3654
Practice Address - Fax:303-853-3656
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor