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NPI Code Detail

MEDICARE: KATHERINE TREIBER PH.D.

MEDICARE: KATHERINE TREIBER PH.D.
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
1103G00000XClinical Neuropsychologist9521MA
2103G00000XClinical Neuropsychologist3155CT
3103TC0700XClinical Psychologist9521MA
4103TC0700XClinical Psychologist3155CT

General Provider Information

NPI Number : 1285995373
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE TREIBER PH.D.
Provider Business Mailing Address
First Line : 1900 W PARK DR
Second Line : SUITE 280
City : WESTBOROUGH
State : MA
Zip : 01581-3942
Country : US
Telephone Number : 508-494-1809
Fax Number :
Provider Business Practice Location Address
First Line : 1900 W PARK DR
Second Line : SUITE 280
City : WESTBOROUGH
State : MA
Zip : 01581-3942
Country : US
Telephone Number : 508-494-1809
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2012
Last Update Date : 06/05/2012

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