Provider Demographics
NPI:1902378615
Name:MEUCCI, KATIE ANNE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ANNE
Last Name:MEUCCI
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 1:55 CHAPEL STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458
Mailing Address - Country:US
Mailing Address - Phone:833-446-6386
Mailing Address - Fax:
Practice Address - Street 1:55 CHAPEL STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458
Practice Address - Country:US
Practice Address - Phone:833-446-6386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator