Provider Demographics
NPI:1417210196
Name:KAPSOLI, CATTY
Entity type:Individual
Prefix:
First Name:CATTY
Middle Name:
Last Name:KAPSOLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 DAHLIA LN
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-5424
Mailing Address - Country:US
Mailing Address - Phone:516-784-0881
Mailing Address - Fax:
Practice Address - Street 1:29 DAHLIA LN
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-5424
Practice Address - Country:US
Practice Address - Phone:516-784-0881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool