Provider Demographics
NPI:1982343117
Name:WILAND, KATHERINE JADE (MSC)
Entity Type:Individual
Prefix:
First Name:KATHERINE JADE
Middle Name:
Last Name:WILAND
Suffix:
Gender:F
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18245 N PIMA RD APT 3073
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6374
Mailing Address - Country:US
Mailing Address - Phone:310-819-2271
Mailing Address - Fax:
Practice Address - Street 1:18245 N PIMA RD APT 3073
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6374
Practice Address - Country:US
Practice Address - Phone:310-819-2271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-04
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No103T00000XBehavioral Health & Social Service ProvidersPsychologist