Provider Demographics
NPI:1912180985
Name:TEIXEIRA, KATHLEEN (BS, CEIS, DS)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:TEIXEIRA
Suffix:
Gender:F
Credentials:BS, CEIS, DS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-4995
Mailing Address - Country:US
Mailing Address - Phone:508-997-1570
Mailing Address - Fax:
Practice Address - Street 1:389 COUNTY ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-4995
Practice Address - Country:US
Practice Address - Phone:508-997-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist