Provider Demographics
NPI:1154489441
Name:DELLA MORA, CATHY (PHD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:DELLA MORA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1216
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-1216
Mailing Address - Country:US
Mailing Address - Phone:614-433-2558
Mailing Address - Fax:614-433-2558
Practice Address - Street 1:7870 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 310
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1319
Practice Address - Country:US
Practice Address - Phone:614-433-2558
Practice Address - Fax:614-433-2558
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4975103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000116780OtherINSURANCE - ANTHEM BCBS
OH000000116780OtherINSURANCE - ANTHEM BCBS