Provider Demographics
NPI:1013436054
Name:PROBHERBS, KATRINA ANASTASIA (MSED)
Entity Type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:ANASTASIA
Last Name:PROBHERBS
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8725 136TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1924
Mailing Address - Country:US
Mailing Address - Phone:718-291-2807
Mailing Address - Fax:718-291-2658
Practice Address - Street 1:8725 136TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1924
Practice Address - Country:US
Practice Address - Phone:347-559-3697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool