Provider Demographics
NPI:1801664750
Name:MCCLOUD, KATRINA (NBC-HWC)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:MCCLOUD
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23145
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11202-3145
Mailing Address - Country:US
Mailing Address - Phone:718-908-1500
Mailing Address - Fax:
Practice Address - Street 1:1566 STERLING PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3297
Practice Address - Country:US
Practice Address - Phone:718-908-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach