Provider Demographics
NPI:1922690478
Name:CIRBO, KATHERINE MARTIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MARTIN
Last Name:CIRBO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8303 HYDRANGEA PATH
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-4788
Mailing Address - Country:US
Mailing Address - Phone:361-850-0987
Mailing Address - Fax:
Practice Address - Street 1:8303 HYDRANGEA PATH
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78015-4788
Practice Address - Country:US
Practice Address - Phone:361-850-0987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38758103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX428456401Medicaid