Provider Demographics
NPI:1093305021
Name:FITZGIBBONS, CATHERINE (MA)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:FITZGIBBONS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 ASHFORD DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7978
Mailing Address - Country:US
Mailing Address - Phone:717-507-1240
Mailing Address - Fax:
Practice Address - Street 1:135 ASHFORD DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7978
Practice Address - Country:US
Practice Address - Phone:717-507-1240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health