Healthcare Provider Details

I. General information

NPI: 1922307065
Provider Name (Legal Business Name): CATHERINE D INGLE M.S., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2011
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 LOCUST AVE
FAIRMONT WV
26554-1321
US

IV. Provider business mailing address

1712 LOCUST AVE
FAIRMONT WV
26554-1321
US

V. Phone/Fax

Practice location:
  • Phone: 304-366-6157
  • Fax: 304-366-0177
Mailing address:
  • Phone: 304-366-6157
  • Fax: 304-366-0177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberA-0011
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-0011
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: