Provider Demographics
NPI:1942332903
Name:RENELLI, CATHERINE LOUISE (ATC, LAT)
Entity Type:Individual
Prefix:MISS
First Name:CATHERINE
Middle Name:LOUISE
Last Name:RENELLI
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1964 VILLAGE GRN S
Mailing Address - Street 2:APT. B
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-4036
Mailing Address - Country:US
Mailing Address - Phone:401-383-3632
Mailing Address - Fax:
Practice Address - Street 1:1964 VILLAGE GRN S
Practice Address - Street 2:APT. B
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-4036
Practice Address - Country:US
Practice Address - Phone:401-383-3632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAT002402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer