Provider Demographics
NPI:1033667928
Name:WALSH, KATIE (MAED, LAT, ATC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:WALSH
Suffix:
Gender:F
Credentials:MAED, LAT, ATC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:SCHULZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 W SEEBOTH ST UNIT 306
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-4322
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3409 N DOWNER AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-2934
Practice Address - Country:US
Practice Address - Phone:847-682-8599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer