Provider Demographics
NPI:1699501395
Name:ELLIS-PATTERSON, CATINA (CPRS, SAS)
Entity type:Individual
Prefix:
First Name:CATINA
Middle Name:
Last Name:ELLIS-PATTERSON
Suffix:
Gender:F
Credentials:CPRS, SAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 ASHLEY HALL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9180
Mailing Address - Country:US
Mailing Address - Phone:839-257-0342
Mailing Address - Fax:
Practice Address - Street 1:178 US HIGHWAY 321 BYP N
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-9251
Practice Address - Country:US
Practice Address - Phone:803-635-2335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist