Provider Demographics
NPI:1952993875
Name:BERGENER, CATHERINE MARY (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:MARY
Last Name:BERGENER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14046 HACKNEY CT
Mailing Address - Street 2:
Mailing Address - City:QUEEN ANNE
Mailing Address - State:MD
Mailing Address - Zip Code:21657-1853
Mailing Address - Country:US
Mailing Address - Phone:443-722-1892
Mailing Address - Fax:
Practice Address - Street 1:14299 BENEDICTINE LN
Practice Address - Street 2:
Practice Address - City:RIDGELY
Practice Address - State:MD
Practice Address - Zip Code:21660-1434
Practice Address - Country:US
Practice Address - Phone:410-634-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05270225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist