Provider Demographics
NPI:1245543479
Name:MCINTOSH, KATIE ELISABETH
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:ELISABETH
Last Name:MCINTOSH
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 1:19 AMVETS AVE
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-3332
Mailing Address - Country:US
Mailing Address - Phone:508-566-9383
Mailing Address - Fax:
Practice Address - Street 1:19 AMVETS AVE
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-3332
Practice Address - Country:US
Practice Address - Phone:508-566-9383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker