Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | LP6710 | |
Y | 103T00000X | Psychologist | LP6710 |
NPI | 1013688308 |
---|---|
Provider Name | Katherine Eleanore Stratton |
First Address | Golden Valley, MN 55422-5167 |
Second Address | Golden Valley, MN 55422-5167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2021 |
Last Update Date | 07/01/2022 |