Provider Demographics
NPI:1093132540
Name:AINSWORTH, CATHERINE (SLP)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:AINSWORTH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 LATTIE LN
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3407
Mailing Address - Country:US
Mailing Address - Phone:415-388-3177
Mailing Address - Fax:
Practice Address - Street 1:1211 LATTIE LN
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3407
Practice Address - Country:US
Practice Address - Phone:415-388-3177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-22
Last Update Date:2014-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist