Provider Demographics
NPI:1225273527
Name:LAWTON, KATIEJO CHARMAINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATIEJO
Middle Name:CHARMAINE
Last Name:LAWTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2404
Mailing Address - Country:US
Mailing Address - Phone:402-659-4560
Mailing Address - Fax:
Practice Address - Street 1:711 S VINE ST
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:IA
Practice Address - Zip Code:51534-1927
Practice Address - Country:US
Practice Address - Phone:712-525-1857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001924225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist