Provider Demographics
NPI:1689077109
Name:CAULEY, KATHERINE LOUISE (LAC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LOUISE
Last Name:CAULEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 SHUTTER RD
Mailing Address - Street 2:
Mailing Address - City:MARYLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12116-2404
Mailing Address - Country:US
Mailing Address - Phone:347-489-1515
Mailing Address - Fax:
Practice Address - Street 1:50 DIETZ ST STE O
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1865
Practice Address - Country:US
Practice Address - Phone:607-386-4636
Practice Address - Fax:607-386-4636
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005306171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist