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NPI Code Detail

MEDICARE: KATHIE DALUM

MEDICARE: KATHIE DALUM
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
1101YM0800XMental Health CounselorLMHC10000663MA

General Provider Information

NPI Number : 1184305922
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHIE DALUM
Provider Business Mailing Address
First Line : 4441 OLD COLLEGE RD APT 7103
Second Line :
City : BRYAN
State : TX
Zip : 77801-3534
Country : US
Telephone Number : 979-739-4385
Fax Number :
Provider Business Practice Location Address
First Line : 23 MELLEN ST FL 5
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-2757
Country : US
Telephone Number : 857-331-6331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2023
Last Update Date : 07/25/2023

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Directions to “ KATHIE DALUM ” Practice Location

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