Provider Demographics
NPI:1427565787
Name:STUDLEY, CATHERINE A (OTR)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:STUDLEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 E GROVE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1816
Mailing Address - Country:US
Mailing Address - Phone:774-634-8555
Mailing Address - Fax:
Practice Address - Street 1:47 E GROVE ST STE 102
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1816
Practice Address - Country:US
Practice Address - Phone:774-634-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1252225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1252OtherPROFESSIONAL LICENSE