Provider Demographics
NPI:1235900655
Name:BOLLERS, CATHERINE ELIZABETH (CERTIFIED PEER SPECI)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:BOLLERS
Suffix:
Gender:F
Credentials:CERTIFIED PEER SPECI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SOUTH EASTON RD.
Mailing Address - Street 2:LOWER LEVEL STE. 104
Mailing Address - City:GLENSIDE, PA
Mailing Address - State:PA
Mailing Address - Zip Code:19038-4525
Mailing Address - Country:US
Mailing Address - Phone:267-858-6730
Mailing Address - Fax:267-287-8047
Practice Address - Street 1:119 SOUTH EASTON RD.
Practice Address - Street 2:LOWER LEVEL STE. 104
Practice Address - City:GLENSIDE, PA
Practice Address - State:PA
Practice Address - Zip Code:19038-4525
Practice Address - Country:US
Practice Address - Phone:267-858-6730
Practice Address - Fax:267-287-8047
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA17654175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist