MEDICARE: MRS. KATRINA MARIE CIAMPA

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	:	1568110294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATRINA MARIE CIAMPA

Provider Business Mailing Address
First Line	:	3 BEAVER POND RD
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-3740
Country	:	US
Telephone Number	:	978-766-2178
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 BEAVER POND RD
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-3740
Country	:	US
Telephone Number	:	978-766-2178
Fax Number	:

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

Provider Enumeration Date	:	03/11/2022
Last Update Date	:	03/11/2022

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