Provider Demographics
NPI:1396307591
Name:STAPLEFORD, CATHERINE (MSED)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:STAPLEFORD
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 E BRONSON ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46615-1140
Mailing Address - Country:US
Mailing Address - Phone:574-315-4320
Mailing Address - Fax:
Practice Address - Street 1:2012 IRONWOOD CIR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1888
Practice Address - Country:US
Practice Address - Phone:574-387-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist