Individual
DR. KATHERINE BOTHOS
Active
Individual
DR. KATHERINE BOTHOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
002950
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004553
CTBPH/BEACON HEALTH VOPTIONS BOTHS,MD
CT
05
—
008025366
—
CT
01
—
06002950CT02
ANTHEM BCBS OF CT- BOTHOS. MD
CT
01
—
12099166
CAQH
CT
01
—
3239811
CIGNA BEHAVIORAL HEALTH BOTHOS, MD
CT
01
—
PENDING
BEACON HEALTH- VALUE OPTIONS AWAKEN THE POWER THERAPY, LLC
CT
Enumeration date
11/17/2009
Last updated
03/21/2017
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