Provider Demographics
NPI:1073889713
Name:LINDEMUTH, KATHERINE ELIZABETH
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:LINDEMUTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:139 OLD COUNTY RD
Mailing Address - City:TRURO
Mailing Address - State:MA
Mailing Address - Zip Code:02666-0544
Mailing Address - Country:US
Mailing Address - Phone:760-580-2483
Mailing Address - Fax:
Practice Address - Street 1:139 0LD COUNTY RD
Practice Address - Street 2:
Practice Address - City:TRURO
Practice Address - State:MA
Practice Address - Zip Code:02666
Practice Address - Country:US
Practice Address - Phone:760-580-2483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14295171100000X
MA251958171100000X
MA10310225X00000X
CA9141225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171100000XOther Service ProvidersAcupuncturist