MEDICARE: KATELYN MARIE TORRES

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1538496559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN MARIE TORRES

Provider Business Mailing Address
First Line	:	22 BELKNAP ST
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02144-1516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 BELKNAP ST
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02144-1516
Country	:	US
Telephone Number	:	781-789-3159
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2009
Last Update Date	:	11/12/2009

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Directions to “ KATELYN MARIE TORRES ” Practice Location

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