Provider Demographics
NPI:1487471454
Name:SIKELIANOS-CARTER, CATHERINE (MA, ATR-BC, LCAT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:SIKELIANOS-CARTER
Suffix:
Gender:F
Credentials:MA, ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1274 ROUTE 29
Mailing Address - Street 2:
Mailing Address - City:GALWAY
Mailing Address - State:NY
Mailing Address - Zip Code:12074-2736
Mailing Address - Country:US
Mailing Address - Phone:805-453-4437
Mailing Address - Fax:
Practice Address - Street 1:1274 ROUTE 29
Practice Address - Street 2:
Practice Address - City:GALWAY
Practice Address - State:NY
Practice Address - Zip Code:12074-2736
Practice Address - Country:US
Practice Address - Phone:805-453-4437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003029221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist