Provider Demographics
NPI:1285995373
Name:TREIBER, KATHERINE (PHD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:TREIBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W PARK DR
Mailing Address - Street 2:SUITE 280
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3942
Mailing Address - Country:US
Mailing Address - Phone:508-494-1809
Mailing Address - Fax:
Practice Address - Street 1:1900 W PARK DR
Practice Address - Street 2:SUITE 280
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3942
Practice Address - Country:US
Practice Address - Phone:508-494-1809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9521103G00000X, 103TC0700X
CT3155103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist