Katrina Breen

Individual provider Active NPI Specialist · Southbridge, MA

NPI 1598089179 · NPPES record last updated Mar 25, 2010

Key facts

NPI
1598089179
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
Practice address
486 Worcester St
Kennedy Donovan Center
Southbridge, MA 01550-1386
Phone
(508) 765-0292
NPI assigned
Mar 25, 2010
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Donovan Center Specialist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Yes

Addresses

Primary practice location

486 Worcester St
Kennedy Donovan Center
Southbridge, MA 01550-1386

Mailing address

486 Worcester St
Kennedy Donovan Center
Southbridge, MA 01550-1386
Phone (508) 765-0292

Other providers in Southbridge, MA

All providers in Southbridge, MA · Specialist in Massachusetts

Sources for this page

Verify at the official NPI Registry.