Katherine Wacholz Agency
NPI #1912542648 in Hayden Lake, Idaho
Provider Information
- NPI Number
- 1912542648
- Entity Type
- Organization
- Organization Name
- Katherine Wacholz Agency
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Nov 18, 2019
- Last Updated
- Nov 18, 2019
Practice Location
- Address
- 5723 E DODD RD
- City
- Hayden Lake
- State
- Idaho
- ZIP Code
- 83835-9376
- Phone
- (208) 699-1704
Authorized Official
- Name
- MRS. KATHERINE WACHOLZ WACHOLZ, M.ED BIP
- Title
- INDEPENDENT PROVIDER PROFESSIONAL
- Phone
- (208) 699-1704
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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