Basic Information
| Provider Information | |||||||||
| NPI: | 1376691030 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WUERTH | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | LEIGH | ||||||||
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| Credential: | M.S., L.L.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24715 LITTLE MACK AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SAINT CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480803207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5867779000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 24715 LITTLE MACK AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SAINT CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480803207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5867779000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 6301007828 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.