Provider Demographics
NPI:1861023145
Name:SCHUTT, KATHY JEAN (BA)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:JEAN
Last Name:SCHUTT
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:JEAN
Other - Last Name:STARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:2925 DEAN PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-7700
Mailing Address - Country:US
Mailing Address - Phone:612-925-8365
Mailing Address - Fax:612-925-8366
Practice Address - Street 1:2925 DEAN PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-7700
Practice Address - Country:US
Practice Address - Phone:612-925-8365
Practice Address - Fax:612-925-8366
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician