Provider Demographics
NPI:1598858573
Name:RESTUCCIA, KATHERINE ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ANN
Last Name:RESTUCCIA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 W BROAD ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-5570
Mailing Address - Country:US
Mailing Address - Phone:610-317-9976
Mailing Address - Fax:
Practice Address - Street 1:227 W BROAD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-5570
Practice Address - Country:US
Practice Address - Phone:610-317-9976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009150L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical