Provider Demographics
NPI:1457142820
Name:GANDOLFO, CATHERINE A (MS)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:GANDOLFO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5416 MINKS POND RD
Mailing Address - Street 2:
Mailing Address - City:BUSHKILL
Mailing Address - State:PA
Mailing Address - Zip Code:18324-8324
Mailing Address - Country:US
Mailing Address - Phone:570-856-2003
Mailing Address - Fax:
Practice Address - Street 1:8 SILK MILL DR
Practice Address - Street 2:
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-1413
Practice Address - Country:US
Practice Address - Phone:201-341-2445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSL002796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist