Provider Demographics
NPI:1750672788
Name:GLOVER, CATHERINE BLISS (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:BLISS
Last Name:GLOVER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:BLISS
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:21 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3003
Mailing Address - Country:US
Mailing Address - Phone:845-238-2742
Mailing Address - Fax:
Practice Address - Street 1:10 WEATHERVANE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:10992-2242
Practice Address - Country:US
Practice Address - Phone:845-496-1966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013563-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist