Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | P0000001573 | TN |
NPI | 1003968348 |
---|---|
Provider Name | Dr. Catherine Ann Capelli |
First Address | Murfreesboro, TN 37130-4984 |
Second Address | Murfreesboro, TN 37130-4984 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0131139 | BCBS PROVIDER NUMBER (01) | TN |
021075 | VALUE OPTIONS PROV. NUMBR (01) | TN |