Provider Demographics
NPI:1164928453
Name:COUCH, CATHARINE ANNE (RD)
Entity Type:Individual
Prefix:
First Name:CATHARINE
Middle Name:ANNE
Last Name:COUCH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-4836
Mailing Address - Country:US
Mailing Address - Phone:352-362-1143
Mailing Address - Fax:
Practice Address - Street 1:624 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4836
Practice Address - Country:US
Practice Address - Phone:352-362-1143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered