Provider Demographics
NPI:1912347683
Name:RAFFA, CATHERINE BADEY (OTR)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:BADEY
Last Name:RAFFA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S BRISTOL ST
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-2933
Mailing Address - Country:US
Mailing Address - Phone:608-220-2976
Mailing Address - Fax:
Practice Address - Street 1:222 S BRISTOL ST
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-2933
Practice Address - Country:US
Practice Address - Phone:608-220-2976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5347-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist