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General NPI Number Information
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NPI Number | 1316576325
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Entity Type | Individual
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Provider Name | DR. KATERYNA KUZUBOVA
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Gender | Female
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 339 MASSACHUSETTS AVE
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City | ARLINGTON
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State | MA
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Zip | 02474-6718
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Country | US
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Telephone | 339-368-7696
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Fax |
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Provider Business Mailing Address
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Address Line | 4 AJ GORDON CT APT 104
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City | S HAMILTON
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State | MA
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Zip | 01982-2347
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Country | US
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Telephone | 351-444-8735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.1100356
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License Number State | OH
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