Provider Demographics
NPI:1952767188
Name:BASHIOUM, CATHERINE L (MS, ATC, LAT, PES)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:BASHIOUM
Suffix:
Gender:F
Credentials:MS, ATC, LAT, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WELSH RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-8239
Mailing Address - Country:US
Mailing Address - Phone:724-288-8504
Mailing Address - Fax:
Practice Address - Street 1:410 PELLIS RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4700
Practice Address - Country:US
Practice Address - Phone:724-689-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0061182255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer