Provider Demographics
NPI:1891751830
Name:THOMPSON, CATHERINE ANNETTE (MSOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANNETTE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4526 SYKESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FINKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21048-2610
Mailing Address - Country:US
Mailing Address - Phone:410-549-8009
Mailing Address - Fax:
Practice Address - Street 1:6655 SYKESVILLE RD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-7966
Practice Address - Country:US
Practice Address - Phone:410-970-7190
Practice Address - Fax:410-970-7195
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04714171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD04714OtherSTATE LICENSE IN OT
MD1049743OtherNBCOT-CERTIFICATION OT