Provider Demographics
NPI:1851767206
Name:KATZ, TAL (PHD)
Entity Type:Individual
Prefix:DR
First Name:TAL
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 HIGHLAND AVE # 1005
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3025
Mailing Address - Country:US
Mailing Address - Phone:617-431-6356
Mailing Address - Fax:
Practice Address - Street 1:163 HIGHLAND AVE # 1005
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3025
Practice Address - Country:US
Practice Address - Phone:617-431-6356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10278103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical