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NPI Code Detail

MEDICARE: DR. KATHERINE SARAH FABRIZIO PH.D.

MEDICARE: DR. KATHERINE SARAH FABRIZIO PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist5551MN

General Provider Information

NPI Number : 1609895531
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHERINE SARAH FABRIZIO PH.D.
Provider Business Mailing Address
First Line : 5200 WILLSON RD STE 150
Second Line :
City : EDINA
State : MN
Zip : 55424-1300
Country : US
Telephone Number : 612-416-3311
Fax Number : 612-416-3311
Provider Business Practice Location Address
First Line : 5200 WILLSON RD STE 150
Second Line :
City : EDINA
State : MN
Zip : 55424-1300
Country : US
Telephone Number : 612-416-3311
Fax Number : 612-416-3311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 04/28/2024

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