Provider Demographics
NPI:1558734533
Name:LONGA, CATHERINE (PHD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LONGA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E PRINCETON ST STE 540
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1424
Mailing Address - Country:US
Mailing Address - Phone:407-303-8877
Mailing Address - Fax:407-303-8811
Practice Address - Street 1:615 E PRINCETON ST STE 540
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1424
Practice Address - Country:US
Practice Address - Phone:407-303-8877
Practice Address - Fax:407-303-8811
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8697103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist