Basic Information
| Provider Information | |||||||||
| NPI: | 1881943868 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CATALOGNA | ||||||||
| FirstName: | KRISTINE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 53 MELROSE ST APT 6F | ||||||||
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| City: | MELROSE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021762252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9785801405 | ||||||||
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| Practice Location | |||||||||
| Address1: | 57 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019702141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787411200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2012 | ||||||||
| LastUpdateDate: | 09/05/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041S0200X | Y | Behavioral Health & Social Service Providers | Social Worker | School | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.