Provider Demographics
NPI:1922610518
Name:LISTON, KATHERINE NOELLE
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:NOELLE
Last Name:LISTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:NOELLE
Other - Last Name:HAFTMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:542 E GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-3110
Mailing Address - Country:US
Mailing Address - Phone:412-736-0113
Mailing Address - Fax:
Practice Address - Street 1:542 E GARDEN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-3110
Practice Address - Country:US
Practice Address - Phone:412-736-0113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician