Individual
DR. KATIE ELIZABETH CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
24500 CENTER RIDGE ROAD, BUILDING 4, SUITE 100, WESTLAKE, OH 44415-5602
(440) 899-1300
Mailing address
61 RIVERSIDE DR, BEREA, OH 44017-1978
(507) 202-2932
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6502
OH
103TC0700X
Clinical Psychologist
4745
MN
103TC0700X
Clinical Psychologist
Primary
6502
OH
103TF0200X
Forensic Psychologist
4745
MN
103TF0200X
Forensic Psychologist
6502
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152304
UCARE
—
01
—
374T1FA
BLUE CROSS BLUE SHIELD OF MN
MN
01
—
A030
CHAMPUS TRIWEST
MN
Enumeration date
04/19/2007
Last updated
11/20/2008
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