Provider Demographics
NPI:1043049893
Name:WINTHER, KATIE
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:WINTHER
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 1:1250 E SHAW AVE APT 174
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7828
Mailing Address - Country:US
Mailing Address - Phone:559-779-5889
Mailing Address - Fax:
Practice Address - Street 1:1250 E SHAW AVE APT 174
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7828
Practice Address - Country:US
Practice Address - Phone:559-779-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)