Healthcare Provider Details

I. General information

NPI: 1255516811
Provider Name (Legal Business Name): CATHERINE VIRGINIA O'HAYER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE VIRGINIA FENWICK PHD

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1427 VINE ST 8TH FLOOR
PHILADELPHIA PA
19102-1031
US

IV. Provider business mailing address

1101 MARKET ST FL 30
PHILADELPHIA PA
19107-2934
US

V. Phone/Fax

Practice location:
  • Phone: 215-831-4611
  • Fax: 215-831-2603
Mailing address:
  • Phone: 215-503-3685
  • Fax: 215-955-2420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS017228
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: