Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003214172 |
---|---|
Provider Name | Katherine Cousin |
First Address | Boston, MA 02134-3006 |
Second Address | Boston, MA 02134-3006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2014 |
Last Update Date | 17/03/2018 |