Provider Demographics
NPI:1497826721
Name:ATKINSON, CATHY ANN (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:ANN
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-1730
Mailing Address - Country:US
Mailing Address - Phone:401-949-1100
Mailing Address - Fax:401-949-7989
Practice Address - Street 1:19 SMITH AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-1730
Practice Address - Country:US
Practice Address - Phone:401-949-1100
Practice Address - Fax:401-949-7989
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAUD00097231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI45-00029OtherUNITED HEALTH CARE
RICA01147Medicaid
RI7785-1OtherBLUE CROSS