Provider Demographics
NPI:1386940351
Name:BARRETT, KATHRYN MARIE-WILKER (MA LMFT)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARIE-WILKER
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MA LMFT
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 477
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-0477
Mailing Address - Country:US
Mailing Address - Phone:612-702-1976
Mailing Address - Fax:952-406-8588
Practice Address - Street 1:600 W 78TH ST STE 10I
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-2601
Practice Address - Country:US
Practice Address - Phone:612-702-1976
Practice Address - Fax:952-406-8588
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2272106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist