Provider Demographics
NPI:1417168659
Name:REARDON, CATHERINE W (MA)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:W
Last Name:REARDON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 W PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2611
Mailing Address - Country:US
Mailing Address - Phone:610-269-8334
Mailing Address - Fax:610-269-9783
Practice Address - Street 1:35 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2611
Practice Address - Country:US
Practice Address - Phone:610-269-8334
Practice Address - Fax:610-269-9783
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT005845237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter