Provider Demographics
NPI:1396099453
Name:MCLEOD, KATHERINE MARIE (CMT)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MARIE
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:CMT
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15635 W 12 MILE RD
Mailing Address - Street 2:SUITE #110
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3048
Mailing Address - Country:US
Mailing Address - Phone:248-559-9995
Mailing Address - Fax:248-559-9995
Practice Address - Street 1:15635 W 12 MILE RD
Practice Address - Street 2:SUITE #110
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3048
Practice Address - Country:US
Practice Address - Phone:248-559-9995
Practice Address - Fax:248-559-9995
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-28
Last Update Date:2012-10-28
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist