Provider Demographics
NPI:1710340104
Name:PINSON, CATHY LYNN
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LYNN
Last Name:PINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:LYNN
Other - Last Name:CRISPEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:122 LANARK CT
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-4357
Mailing Address - Country:US
Mailing Address - Phone:616-328-0087
Mailing Address - Fax:
Practice Address - Street 1:122 LANARK CT
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-4357
Practice Address - Country:US
Practice Address - Phone:616-328-0087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006539225X00000X
TX117253225X00000X
IN31005790A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist