Provider Demographics
NPI:1891068870
Name:RIVERA, CATHERINE CAROL (PT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:CAROL
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31985 LA HIGHWAY 16
Mailing Address - Street 2:SUITE C
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-1462
Mailing Address - Country:US
Mailing Address - Phone:225-791-7114
Mailing Address - Fax:225-791-7118
Practice Address - Street 1:31985 LA HIGHWAY 16
Practice Address - Street 2:SUITE C
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-1462
Practice Address - Country:US
Practice Address - Phone:225-791-7114
Practice Address - Fax:225-791-7118
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08261R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist