Provider Demographics
NPI:1609151141
Name:BEATTY, CATHERINE ANN (LMT)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ANN
Last Name:BEATTY
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 1:4811 DAYLON CT
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-3114
Mailing Address - Country:US
Mailing Address - Phone:440-967-2384
Mailing Address - Fax:
Practice Address - Street 1:4811 DAYLON CT
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-3114
Practice Address - Country:US
Practice Address - Phone:440-967-2384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6038225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist