Provider Demographics
NPI:1487668984
Name:DISANTI, CATHERINE A (AUD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:DISANTI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8818 CENTRE PARK DRIVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045
Mailing Address - Country:US
Mailing Address - Phone:410-740-4885
Mailing Address - Fax:410-740-4677
Practice Address - Street 1:8818 CENTRE PARK DRIVE
Practice Address - Street 2:SUITE 107
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045
Practice Address - Country:US
Practice Address - Phone:410-740-4885
Practice Address - Fax:410-740-4677
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00490231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00444722OtherRAILROAD MEDICARE PIN NUMBER
MD739M0379Medicare PIN