Provider Demographics
NPI:1477842599
Name:TAVERAS, CATHERINE M
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:M
Last Name:TAVERAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:M
Other - Last Name:COLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2554 BEAL ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-2452
Mailing Address - Country:US
Mailing Address - Phone:386-748-4619
Mailing Address - Fax:
Practice Address - Street 1:2554 BEAL ST
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-2452
Practice Address - Country:US
Practice Address - Phone:386-748-4619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker