Provider Demographics
NPI:1801251533
Name:CATUARA, KATHERINE L (PSYD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:CATUARA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:L
Other - Last Name:POHOLIK-CATUARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, CSAC
Mailing Address - Street 1:N2846 STATE ROAD 67
Mailing Address - Street 2:
Mailing Address - City:WILLIAMS BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53191-3771
Mailing Address - Country:US
Mailing Address - Phone:262-245-5608
Mailing Address - Fax:262-245-5648
Practice Address - Street 1:N2846 STATE ROAD 67
Practice Address - Street 2:
Practice Address - City:WILLIAMS BAY
Practice Address - State:WI
Practice Address - Zip Code:53191-3771
Practice Address - Country:US
Practice Address - Phone:262-245-5608
Practice Address - Fax:262-245-5648
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3330-57103TC0700X
IL071-008419103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical