Provider Demographics
NPI:1285804757
Name:FRUHAUFF, KATHERINE RUTH PIERSON (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:RUTH PIERSON
Last Name:FRUHAUFF
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:FRUHAUFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:2530 CRAWFORD AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4954
Mailing Address - Country:US
Mailing Address - Phone:224-408-0019
Mailing Address - Fax:855-217-0165
Practice Address - Street 1:2530 CRAWFORD AVE STE 104
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4954
Practice Address - Country:US
Practice Address - Phone:224-408-0019
Practice Address - Fax:855-217-0165
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007441103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical