Provider Demographics
NPI:1235618208
Name:WEST, KATHERINE (OTR/L, OTD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:OTR/L, OTD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:BROWNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, OTD
Mailing Address - Street 1:112 HERRON ST
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-3126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:112 HERRON ST
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3126
Practice Address - Country:US
Practice Address - Phone:706-861-7471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5958OtherOT LICENSE