Provider Demographics
NPI:1356834006
Name:FROMM, KATHLEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:FROMM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:FROMM
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:96 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-1537
Mailing Address - Country:US
Mailing Address - Phone:781-400-1886
Mailing Address - Fax:781-400-1886
Practice Address - Street 1:96 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-1537
Practice Address - Country:US
Practice Address - Phone:781-400-1886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7504-PY-PR103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical