Provider Demographics
NPI:1639764053
Name:PRICE, CATHERINE ALEASE
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ALEASE
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ADDISON WAY APT 14-1B
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-9292
Mailing Address - Country:US
Mailing Address - Phone:806-663-0695
Mailing Address - Fax:804-733-1000
Practice Address - Street 1:300 ADDISON WAY APT 14-1B
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9292
Practice Address - Country:US
Practice Address - Phone:806-663-0695
Practice Address - Fax:804-733-1000
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator