Provider Demographics
NPI:1447630629
Name:DULLE, CATHERINE
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:DULLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2127 INNERBELT BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-5700
Mailing Address - Country:US
Mailing Address - Phone:314-898-3944
Mailing Address - Fax:314-506-8870
Practice Address - Street 1:605 COEUR DE VILLE DR
Practice Address - Street 2:REHAB DEPARTMENT
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6603
Practice Address - Country:US
Practice Address - Phone:314-453-7311
Practice Address - Fax:314-548-6755
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist