Provider Demographics
NPI:1740218056
Name:TOWNSEND, CATHERINE B (OT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:B
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:BONNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3410 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-3729
Mailing Address - Country:US
Mailing Address - Phone:903-792-3003
Mailing Address - Fax:903-792-3003
Practice Address - Street 1:3410 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-3729
Practice Address - Country:US
Practice Address - Phone:903-792-3003
Practice Address - Fax:903-792-3003
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105633225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ART83813OtherBLUE CROSS
AR125779721Medicaid
TX8T6081OtherBLUE CROSS