Provider Demographics
NPI:1013030394
Name:CROWLEY, CATHERINE C (OTD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:C
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N ISABEL ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-3319
Mailing Address - Country:US
Mailing Address - Phone:818-545-0797
Mailing Address - Fax:
Practice Address - Street 1:6340 VARIEL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2514
Practice Address - Country:US
Practice Address - Phone:818-888-4559
Practice Address - Fax:818-888-4005
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 6079174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist