Healthcare Provider Details

I. General information

NPI: 1669493409
Provider Name (Legal Business Name): GWYN MORWENA CATTELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GWYN CATTELL HARVEY MD

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 GALVIN RD
WHITING VT
05778-4400
US

IV. Provider business mailing address

84 GALVIN RD
WHITING VT
05778-4400
US

V. Phone/Fax

Practice location:
  • Phone: 978-480-0033
  • Fax: 802-623-6732
Mailing address:
  • Phone: 802-349-1636
  • Fax: 802-623-6732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number150638
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number042.0013341
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number150638
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number042.0013341
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: