Provider Demographics
NPI:1326404914
Name:PYHALA, KATIE
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:PYHALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:SAWYER
Other - Last Name:LEMIEUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:1761 N HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-5659
Mailing Address - Country:US
Mailing Address - Phone:864-230-1054
Mailing Address - Fax:
Practice Address - Street 1:1761 N HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-5659
Practice Address - Country:US
Practice Address - Phone:864-230-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1-15-21258103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst