Provider Demographics
NPI:1194218743
Name:BOYD, KATHERINE ADCOCK (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ADCOCK
Last Name:BOYD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:MICHELLE
Other - Last Name:ADCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18242 OAK LANE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3718
Mailing Address - Country:US
Mailing Address - Phone:502-640-5040
Mailing Address - Fax:
Practice Address - Street 1:5130 MANCUSO LN
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3583
Practice Address - Country:US
Practice Address - Phone:225-490-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200604225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist