Healthcare Provider Details

I. General information

NPI: 1952701286
Provider Name (Legal Business Name): CATHY URBAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 08/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 COVENTRY CT
HOLLIDAYSBURG PA
16648-2931
US

IV. Provider business mailing address

312 COVENTRY CT
HOLLIDAYSBURG PA
16648-2931
US

V. Phone/Fax

Practice location:
  • Phone: 570-575-5881
  • Fax:
Mailing address:
  • Phone: 570-575-5881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOP005728
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: