Provider Demographics
NPI:1982830592
Name:WICKE LAPLANTE, KATHERINE ELIZABETH (MS, LPA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:WICKE LAPLANTE
Suffix:
Gender:F
Credentials:MS, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 S MAIN ST STE J
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-3366
Mailing Address - Country:US
Mailing Address - Phone:336-229-4624
Mailing Address - Fax:
Practice Address - Street 1:202 S MAIN ST STE J
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-3366
Practice Address - Country:US
Practice Address - Phone:336-229-4624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2619103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist