Provider Demographics
NPI:1518555820
Name:WOODS, CATHERINE ELIZABETH (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:WOODS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 S MAIN ST APT 240
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-3049
Mailing Address - Country:US
Mailing Address - Phone:585-694-5773
Mailing Address - Fax:
Practice Address - Street 1:709 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-1669
Practice Address - Country:US
Practice Address - Phone:315-937-5954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031309225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty