Provider Demographics
NPI:1245601160
Name:ZAMORE, KATHERINE (MED, EDS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ZAMORE
Suffix:
Gender:F
Credentials:MED, EDS
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:BUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, EDS
Mailing Address - Street 1:1735 KILBOURNE PL NW
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2668
Mailing Address - Country:US
Mailing Address - Phone:978-495-2561
Mailing Address - Fax:
Practice Address - Street 1:1755 NEWTON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-1823
Practice Address - Country:US
Practice Address - Phone:978-495-2561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool