Provider Demographics
NPI:1689006579
Name:VITAGLIANO, CATRINA LOUISE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CATRINA
Middle Name:LOUISE
Last Name:VITAGLIANO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 JACKSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-4807
Mailing Address - Country:US
Mailing Address - Phone:215-355-2011
Mailing Address - Fax:
Practice Address - Street 1:882 JACKSONVILLE RD
Practice Address - Street 2:
Practice Address - City:IVYLAND
Practice Address - State:PA
Practice Address - Zip Code:18974-4807
Practice Address - Country:US
Practice Address - Phone:215-355-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017421103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical