Provider Demographics
NPI:1134463128
Name:KAFKA, KATIE CHRISTINE
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:CHRISTINE
Last Name:KAFKA
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 1:11710 OLD GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2653
Mailing Address - Country:US
Mailing Address - Phone:301-904-2885
Mailing Address - Fax:
Practice Address - Street 1:8001 LYNBROOK DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4642
Practice Address - Country:US
Practice Address - Phone:301-657-4959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
06998225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist