Provider Demographics
NPI:1588127823
Name:MANERS, CATHY A
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:A
Last Name:MANERS
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 1:2246 N 600 W
Mailing Address - Street 2:
Mailing Address - City:THORNTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46071-8813
Mailing Address - Country:US
Mailing Address - Phone:317-502-2374
Mailing Address - Fax:
Practice Address - Street 1:2246 N 600 W
Practice Address - Street 2:
Practice Address - City:THORNTOWN
Practice Address - State:IN
Practice Address - Zip Code:46071-8813
Practice Address - Country:US
Practice Address - Phone:317-502-2374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist