Provider Demographics
NPI:1699443416
Name:NONNEMACHER, CATHERINE REBECCA
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:REBECCA
Last Name:NONNEMACHER
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 1:198 PINEY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:JIM THORPE
Mailing Address - State:PA
Mailing Address - Zip Code:18229-2764
Mailing Address - Country:US
Mailing Address - Phone:570-657-5293
Mailing Address - Fax:
Practice Address - Street 1:198 PINEY WOODS DR
Practice Address - Street 2:
Practice Address - City:JIM THORPE
Practice Address - State:PA
Practice Address - Zip Code:18229-2764
Practice Address - Country:US
Practice Address - Phone:570-657-5293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-06
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012692101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional