Provider Demographics
NPI:1619154077
Name:BARKER, CATHERINE JOY (RPT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:JOY
Last Name:BARKER
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:JOY
Other - Last Name:COSTELLO-BARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:729 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4217
Mailing Address - Country:US
Mailing Address - Phone:757-873-2932
Mailing Address - Fax:757-873-8780
Practice Address - Street 1:729 THIMBLE SHOALS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4217
Practice Address - Country:US
Practice Address - Phone:757-873-2932
Practice Address - Fax:757-873-8780
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23050032152251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics