Provider Demographics
NPI:1083481691
Name:THIEL, KATHERINE AUBREY
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:AUBREY
Last Name:THIEL
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 1:3700 E WILLIAMS FIELD RD APT 3019
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-2020
Mailing Address - Country:US
Mailing Address - Phone:307-752-0386
Mailing Address - Fax:
Practice Address - Street 1:1702 S PIERPONT DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4697
Practice Address - Country:US
Practice Address - Phone:602-844-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist