Provider Demographics
NPI:1386264489
Name:OTTO-HADLEY, CATHERINE (MT-BC)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:OTTO-HADLEY
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767 ENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3601
Mailing Address - Country:US
Mailing Address - Phone:585-329-6129
Mailing Address - Fax:
Practice Address - Street 1:6767 ENFIELD DR
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-3601
Practice Address - Country:US
Practice Address - Phone:585-329-6129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE