Provider Demographics
NPI:1245535095
Name:SMITH, CATHERINE CLARE (OTR)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:CLARE
Last Name:SMITH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:CLARE
Other - Last Name:MCNAMARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:PO BOX 700
Mailing Address - Street 2:ROUTE 302 PINE BUSH SCHOOLS
Mailing Address - City:PINE BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12566
Mailing Address - Country:US
Mailing Address - Phone:845-744-2031
Mailing Address - Fax:845-744-2241
Practice Address - Street 1:ROUTE 302
Practice Address - Street 2:PINE BUSH SCHOOLS
Practice Address - City:PINE BUSH
Practice Address - State:NY
Practice Address - Zip Code:12566
Practice Address - Country:US
Practice Address - Phone:845-744-2031
Practice Address - Fax:845-744-2241
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004492-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist