Provider Demographics
NPI:1679846554
Name:FEENSTRA, CATHERINE B
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:B
Last Name:FEENSTRA
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 1:100 QUARRY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-1339
Mailing Address - Country:US
Mailing Address - Phone:973-209-4064
Mailing Address - Fax:973-209-4867
Practice Address - Street 1:100 QUARRY RD
Practice Address - Street 2:SUITE C
Practice Address - City:HAMBURG
Practice Address - State:NJ
Practice Address - Zip Code:07419-1339
Practice Address - Country:US
Practice Address - Phone:973-209-4064
Practice Address - Fax:973-209-4867
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00146700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist