Provider Demographics
NPI:1265120299
Name:WILLOWS, CATHERINE ANN
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:WILLOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MANVILLE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1937
Mailing Address - Country:US
Mailing Address - Phone:413-629-8911
Mailing Address - Fax:
Practice Address - Street 1:4 MANVILLE ST APT 4
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1937
Practice Address - Country:US
Practice Address - Phone:413-629-8911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171400000X
MARN2313958163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No171400000XOther Service ProvidersHealth & Wellness Coach