Provider Demographics
NPI:1528781796
Name:HANIGAN, CATHERINE ROSE (PSYD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ROSE
Last Name:HANIGAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ROSE
Other - Last Name:DONATONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44-129 PUUOHALAI PL
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2545
Mailing Address - Country:US
Mailing Address - Phone:757-619-6903
Mailing Address - Fax:
Practice Address - Street 1:480 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JBPHH
Practice Address - State:HI
Practice Address - Zip Code:96860-4908
Practice Address - Country:US
Practice Address - Phone:757-619-6903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
VA0810008037103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist