Healthcare Provider Details

I. General information

NPI: 1538277702
Provider Name (Legal Business Name): CATHERINE E LOSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 E 10TH ST STE B
JEFFERSONVILLE IN
47130-7100
US

IV. Provider business mailing address

6626 DOVIR WOODS DR
SELLERSBURG IN
47172-9152
US

V. Phone/Fax

Practice location:
  • Phone: 812-496-4310
  • Fax: 812-329-3945
Mailing address:
  • Phone: 502-802-5992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1695
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: