Provider Demographics
NPI:1780260356
Name:MOLONEY, CATHERINE GRACE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:GRACE
Last Name:MOLONEY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 COLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:BYFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01922-2801
Mailing Address - Country:US
Mailing Address - Phone:302-757-5648
Mailing Address - Fax:
Practice Address - Street 1:176 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-3230
Practice Address - Country:US
Practice Address - Phone:781-593-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13869222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist