Provider Demographics
NPI:1114461423
Name:MORETTI, KATHERINE (M ED)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:MORETTI
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 BRIDGE ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-5043
Mailing Address - Country:US
Mailing Address - Phone:703-402-3391
Mailing Address - Fax:
Practice Address - Street 1:6 ECHO AVE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2417
Practice Address - Country:US
Practice Address - Phone:978-927-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA426641235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist