Provider Demographics
NPI:1043725419
Name:STROTT, KATHLEEN
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:STROTT
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 1:340 N ALLEGHANY RD
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1404
Mailing Address - Country:US
Mailing Address - Phone:847-543-5907
Mailing Address - Fax:
Practice Address - Street 1:340 N ALLEGHANY RD
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1404
Practice Address - Country:US
Practice Address - Phone:847-543-5907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool