Provider Demographics
NPI:1851447197
Name:LOVETT, CATHY
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:
Last Name:LOVETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RIGHT DIRECTION
Other - Middle Name:CHILD DEVELOPMENT
Other - Last Name:SERVICES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6322 SWAMP FOX HWY W
Mailing Address - Street 2:
Mailing Address - City:TABOR CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28463-8624
Mailing Address - Country:US
Mailing Address - Phone:910-653-9314
Mailing Address - Fax:910-653-9314
Practice Address - Street 1:6322 SWAMP FOX HWY W
Practice Address - Street 2:
Practice Address - City:TABOR CITY
Practice Address - State:NC
Practice Address - Zip Code:28463-8624
Practice Address - Country:US
Practice Address - Phone:910-653-9314
Practice Address - Fax:910-653-9314
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00014174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301326Medicaid
NC8301326KMedicaid