Healthcare Provider Details

I. General information

NPI: 1558447706
Provider Name (Legal Business Name): CATHERINE M MACGREGOR PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 RIDGELAKE DR SUITE 219
METAIRIE LA
70002-3836
US

IV. Provider business mailing address

3350 RIDGELAKE STE 219
METAIRIE LA
70002
US

V. Phone/Fax

Practice location:
  • Phone: 504-243-5122
  • Fax: 985-781-4319
Mailing address:
  • Phone: 504-455-8647
  • Fax: 985-781-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number829
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: