Provider Demographics
NPI:1194849927
Name:WASHINGTON, KATRICE LASHELLE (OT)
Entity Type:Individual
Prefix:MISS
First Name:KATRICE
Middle Name:LASHELLE
Last Name:WASHINGTON
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 1:45 S MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3325
Mailing Address - Country:US
Mailing Address - Phone:610-564-4942
Mailing Address - Fax:
Practice Address - Street 1:45 S MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-3325
Practice Address - Country:US
Practice Address - Phone:610-564-4912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008497224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant