Provider Demographics
NPI:1689494155
Name:STRONG, KATHRYN DAWNINE
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DAWNINE
Last Name:STRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:DAWNINE
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACC
Mailing Address - Street 1:8242 BUTTERNUT DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-1109
Mailing Address - Country:US
Mailing Address - Phone:916-745-9254
Mailing Address - Fax:
Practice Address - Street 1:8242 BUTTERNUT DR
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-1109
Practice Address - Country:US
Practice Address - Phone:916-745-9254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
CA009614997I171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
009614997IOtherINTERNATIONAL COACHING FEDERATION