Provider Demographics
NPI:1912146077
Name:CAROTHERS, CATHLEEN S (MS)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:S
Last Name:CAROTHERS
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 1:2106 HAWKSBURY WAY
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-6878
Mailing Address - Country:US
Mailing Address - Phone:214-213-5860
Mailing Address - Fax:
Practice Address - Street 1:2106 HAWKSBURY WAY
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6878
Practice Address - Country:US
Practice Address - Phone:214-213-5860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist
No174400000XOther Service ProvidersSpecialist