Provider Demographics
NPI:1215648688
Name:BADER, M CATHERINE
Entity type:Individual
Prefix:
First Name:M CATHERINE
Middle Name:
Last Name:BADER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATIE
Other - Middle Name:
Other - Last Name:BADER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1540 BROWNLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3928
Mailing Address - Country:US
Mailing Address - Phone:937-776-4581
Mailing Address - Fax:
Practice Address - Street 1:1540 BROWNLEIGH RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-3928
Practice Address - Country:US
Practice Address - Phone:937-776-4581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator