Provider Demographics
NPI:1588144984
Name:COLE, CATHERINE STEVENS (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:STEVENS
Last Name:COLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:12913-1901
Mailing Address - Country:US
Mailing Address - Phone:423-774-7185
Mailing Address - Fax:
Practice Address - Street 1:26 MAIN ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:12913-1901
Practice Address - Country:US
Practice Address - Phone:423-774-7185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021256-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist