Provider Demographics
NPI:1679588248
Name:CAUTHORNE, CATHERINE GORDON (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:GORDON
Last Name:CAUTHORNE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 ELM ST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1000
Mailing Address - Country:US
Mailing Address - Phone:603-924-6005
Mailing Address - Fax:603-924-6033
Practice Address - Street 1:80 ELM ST
Practice Address - Street 2:SUITE 11
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1000
Practice Address - Country:US
Practice Address - Phone:603-924-6005
Practice Address - Fax:603-924-6033
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH567103T00000X
VT590103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE3046Medicare ID - Type UnspecifiedPSYCHOLOGY