Provider Demographics
NPI:1871324269
Name:DALZIEL, KATHARINE ANNA
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ANNA
Last Name:DALZIEL
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3519
Mailing Address - Country:US
Mailing Address - Phone:503-372-5147
Mailing Address - Fax:
Practice Address - Street 1:113 N ELM ST
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3519
Practice Address - Country:US
Practice Address - Phone:033-725-1475
Practice Address - Fax:503-650-4302
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health