Provider Demographics
NPI:1629261268
Name:LUZADDER, CATHERINE B
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:B
Last Name:LUZADDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAHTERINE
Other - Middle Name:B
Other - Last Name:MELDRIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:1460 N PINAL AVE
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-3337
Mailing Address - Country:US
Mailing Address - Phone:520-876-3627
Mailing Address - Fax:
Practice Address - Street 1:1460 N PINAL AVE
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-3337
Practice Address - Country:US
Practice Address - Phone:520-876-3627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool