Provider Demographics
NPI:1578758777
Name:BRISTOW, CATHERINE (LPCMH)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BRISTOW
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-4033
Mailing Address - Country:US
Mailing Address - Phone:302-502-2001
Mailing Address - Fax:
Practice Address - Street 1:1112 ELM ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4033
Practice Address - Country:US
Practice Address - Phone:302-502-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor