Provider Demographics
NPI:1992569891
Name:WHALEY, CATHERINE MARIE
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:WHALEY
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 1:2024 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-2417
Mailing Address - Country:US
Mailing Address - Phone:740-414-0870
Mailing Address - Fax:740-894-4827
Practice Address - Street 1:432 PRIVATE DRIVE 288
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-7900
Practice Address - Country:US
Practice Address - Phone:740-894-4749
Practice Address - Fax:740-894-4827
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4583SC156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician