Organization
CATHERINE CLODFELTER PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. CATHERINE CLODFELTER PHD (OWNER)
(336) 659-9440
Entity
Organization
Contact information
Practice address
3000 BETHESDA PL STE 102, WINSTON SALEM, NC 27103-3323
(336) 965-9944
(336) 659-9845
Mailing address
PO BOX 24937, WINSTON SALEM, NC 27114-4937
(336) 659-9440
(336) 659-9845
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1575
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0338N
BCBS
NC
05
—
600336
—
NC
Enumeration date
03/12/2008
Last updated
09/02/2010
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