Provider Demographics
NPI:1720367071
Name:STOBAUGH, CATHERINE COCKING (MED MTS LCDC CSAT)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:COCKING
Last Name:STOBAUGH
Suffix:
Gender:F
Credentials:MED MTS LCDC CSAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10632 NORTHBORO ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-4453
Mailing Address - Country:US
Mailing Address - Phone:214-692-0103
Mailing Address - Fax:
Practice Address - Street 1:10632 NORTHBORO ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-4453
Practice Address - Country:US
Practice Address - Phone:214-692-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2868101YM0800X
TXTDSHS2868101YM0800X
TXTDSHS2686101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health