Provider Demographics
NPI:1104684885
Name:HINDAHL, KATIE (NBCHWC)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:
Last Name:HINDAHL
Suffix:
Gender:F
Credentials:NBCHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:OZONA
Mailing Address - State:FL
Mailing Address - Zip Code:34660-0524
Mailing Address - Country:US
Mailing Address - Phone:727-265-1246
Mailing Address - Fax:
Practice Address - Street 1:455 ALT 19 S APT 153
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-5930
Practice Address - Country:US
Practice Address - Phone:727-265-1246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA-3401830171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach