Provider Demographics
NPI:1528033131
Name:FEDDER, CATHERINE MARIE (ATC, MA, LATC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MARIE
Last Name:FEDDER
Suffix:
Gender:F
Credentials:ATC, MA, LATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 WOODLAND CT
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3348
Mailing Address - Country:US
Mailing Address - Phone:574-532-7554
Mailing Address - Fax:
Practice Address - Street 1:115 WOODLAND CT
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3348
Practice Address - Country:US
Practice Address - Phone:574-532-7554
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN36000009OtherHEALTH PROFESSIONS BUREAU