Provider Demographics
NPI:1801104922
Name:COOPER, CATHERINE LOUISE (OT/L, CHT, LANA-CLT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LOUISE
Last Name:COOPER
Suffix:
Gender:F
Credentials:OT/L, CHT, LANA-CLT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:LOUISE
Other - Last Name:WITHROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT/L, CHT, LANA-CLT
Mailing Address - Street 1:100 WIMBLEDON SQ
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4931
Mailing Address - Country:US
Mailing Address - Phone:757-547-5145
Mailing Address - Fax:757-539-7488
Practice Address - Street 1:100 WIMBLEDON SQ
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4931
Practice Address - Country:US
Practice Address - Phone:757-547-5145
Practice Address - Fax:757-539-7488
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003500225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist