Provider Demographics
NPI:1689815003
Name:SCHULTZ, CATHERINE IVY
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:IVY
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:IVY
Other - Last Name:CONNORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:497 MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1298
Mailing Address - Country:US
Mailing Address - Phone:978-448-4001
Mailing Address - Fax:
Practice Address - Street 1:497 MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1298
Practice Address - Country:US
Practice Address - Phone:978-448-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-14
Last Update Date:2009-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA82225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist