Provider Demographics
NPI:1295223386
Name:ARNESON, CATHRINE MICHELLE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CATHRINE
Middle Name:MICHELLE
Last Name:ARNESON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 PETTIBONE ST. #101A
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178
Mailing Address - Country:US
Mailing Address - Phone:947-222-5439
Mailing Address - Fax:
Practice Address - Street 1:321 PETTIBONE ST. #101A
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178
Practice Address - Country:US
Practice Address - Phone:947-222-5439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIM671372225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist