Provider Demographics
NPI:1831617588
Name:WINFREY, KATHRYN (MS, LCGC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WINFREY
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 CEDAR ST SE STE 405
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4924
Mailing Address - Country:US
Mailing Address - Phone:505-764-9535
Mailing Address - Fax:
Practice Address - Street 1:201 CEDAR ST SE STE 405
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4924
Practice Address - Country:US
Practice Address - Phone:505-764-9535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMTGC2017-019170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS