Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003461765 |
---|---|
Provider Name | Taiana Katsaras |
First Address | Cambridge, MA 02139-1099 |
Second Address | Cambridge, MA 02139-1099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2019 |
Last Update Date | 08/08/2019 |