Healthcare Provider Details

I. General information

NPI: 1497238141
Provider Name (Legal Business Name): KATHY KUHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 BARBARA RD
WALTHAM MA
02453-6954
US

IV. Provider business mailing address

93 BARBARA RD
WALTHAM MA
02453-6954
US

V. Phone/Fax

Practice location:
  • Phone: 617-877-3975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number102736
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: