Individual
DR. KATHERINE TRACY MUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1 FITCHBURG ST, #C410, SOMERVILLE, MA 02143-2136
(617) 764-1886
Mailing address
1 FITCHBURG ST, #C410, SOMERVILLE, MA 02143-2136
(617) 764-1886
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6007
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W04826
BCBSMA PROVIDER ID
MA
Enumeration date
02/08/2007
Last updated
07/08/2007
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