Provider Demographics
NPI:1265758197
Name:CATER THERAPY PC
Entity type:Organization
Organization Name:CATER THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CATER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:406-579-6853
Mailing Address - Street 1:1212 S PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-5943
Mailing Address - Country:US
Mailing Address - Phone:406-579-6853
Mailing Address - Fax:
Practice Address - Street 1:205 HAGGERTY LN STE 260
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8801
Practice Address - Country:US
Practice Address - Phone:406-579-6853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT551101YP2500X
MT17225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT347646Medicaid