Provider Demographics
NPI:1396026365
Name:FLYNN, CATHERINE AURELIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:AURELIA
Last Name:FLYNN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 ARDWICK RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3901
Mailing Address - Country:US
Mailing Address - Phone:614-746-0811
Mailing Address - Fax:
Practice Address - Street 1:1489 ARDWICK RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3901
Practice Address - Country:US
Practice Address - Phone:614-746-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3641103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical