Provider Demographics
NPI:1275518094
Name:CHANIN, CATHY SUE (MPH, OTR)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:SUE
Last Name:CHANIN
Suffix:
Gender:F
Credentials:MPH, OTR
Other - Prefix:MISS
Other - First Name:CATHY
Other - Middle Name:SUE
Other - Last Name:YALOWICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH, OTR
Mailing Address - Street 1:PSC 78
Mailing Address - Street 2:BOX 885
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96326
Mailing Address - Country:US
Mailing Address - Phone:0118-131-1755
Mailing Address - Fax:
Practice Address - Street 1:YOKOTA EDIS
Practice Address - Street 2:USNH YOKOTA, BLDG 1374
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96326
Practice Address - Country:US
Practice Address - Phone:0118-131-1755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK811171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider