Provider Demographics
NPI:1922307065
Name:INGLE, CATHERINE D (MS, CCC-A)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:D
Last Name:INGLE
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-1321
Mailing Address - Country:US
Mailing Address - Phone:304-366-6157
Mailing Address - Fax:304-366-0177
Practice Address - Street 1:1712 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-1321
Practice Address - Country:US
Practice Address - Phone:304-366-6157
Practice Address - Fax:304-366-0177
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA-0011237700000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810020625Medicaid