Provider Demographics
NPI:1467034496
Name:TEFFT, KATIE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:TEFFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 HILL RD
Mailing Address - Street 2:
Mailing Address - City:DUMMER
Mailing Address - State:NH
Mailing Address - Zip Code:03588-5409
Mailing Address - Country:US
Mailing Address - Phone:603-828-2846
Mailing Address - Fax:
Practice Address - Street 1:175 N BEACON ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2751
Practice Address - Country:US
Practice Address - Phone:603-828-2846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical