Healthcare Provider Details

I. General information

NPI: 1992953418
Provider Name (Legal Business Name): KATHRYN KRAFT PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 BROAD MEADOW RD
NEEDHAM MA
02492-4326
US

IV. Provider business mailing address

153 BROAD MEADOW RD
NEEDHAM MA
02492-4326
US

V. Phone/Fax

Practice location:
  • Phone: 781-650-3788
  • Fax:
Mailing address:
  • Phone: 781-650-3788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number11796
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: