Healthcare Provider Details

I. General information

NPI: 1992001325
Provider Name (Legal Business Name): KATE LOUISE MARTIN HINRICHS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE LOUISE MARTIN

II. Dates (important events)

Enumeration Date: 02/02/2011
Last Update Date: 07/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 BELMONT ST VA BOSTON HCS; (GEC-181)
BROCKTON MA
02301-5596
US

IV. Provider business mailing address

940 BELMONT ST VA BOSTON HCS; (GEC-181)
BROCKTON MA
02301-5596
US

V. Phone/Fax

Practice location:
  • Phone: 774-826-3451
  • Fax: 774-826-2643
Mailing address:
  • Phone: 774-826-3451
  • Fax: 774-826-2643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 24064
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 24064
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: