Provider Demographics
NPI:1912116930
Name:PANGBORN, KATHERINE VICTORIA ROWLAND (MA)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:VICTORIA ROWLAND
Last Name:PANGBORN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3035
Mailing Address - Country:US
Mailing Address - Phone:413-437-4484
Mailing Address - Fax:413-529-7889
Practice Address - Street 1:35 STATE ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3035
Practice Address - Country:US
Practice Address - Phone:413-437-4484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health