Provider Demographics
NPI:1649606682
Name:COONEY, KATHARINE NOELLE (BA)
Entity type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:NOELLE
Last Name:COONEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:KATHARINE
Other - Middle Name:NOELLE
Other - Last Name:RIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:16 MEEHAN ST
Mailing Address - Street 2:APT 2
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3610
Mailing Address - Country:US
Mailing Address - Phone:617-510-0448
Mailing Address - Fax:
Practice Address - Street 1:51 WATER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4611
Practice Address - Country:US
Practice Address - Phone:617-923-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst