Provider Demographics
NPI:1164844999
Name:GARRETT, KATIE (OT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2603
Mailing Address - Country:US
Mailing Address - Phone:603-524-9090
Mailing Address - Fax:603-524-1497
Practice Address - Street 1:806 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2603
Practice Address - Country:US
Practice Address - Phone:603-524-9090
Practice Address - Fax:603-524-1497
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2325225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist