Kathleen Ricci

Individual provider Active NPI Contractor · Brookline, MA

NPI 1346690328 · NPPES record last updated Jun 21, 2016

Key facts

NPI
1346690328
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
11981 (MA)
Practice address
118 Coolidge St
Brookline, MA 02446-5808
Phone
(978) 482-2498
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11981MAMDClinical Neuropsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 11981 MA Yes

Addresses

Primary practice location

118 Coolidge St
Brookline, MA 02446-5808

Mailing address

118 Coolidge St
Brookline, MA 02446-5808

Other providers in Brookline, MA

All providers in Brookline, MA · Contractor in Massachusetts

Sources for this page

Verify at the official NPI Registry.