Provider Demographics
NPI:1326130493
Name:OSTERFELD, KATHLEEN M (OT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:M
Last Name:OSTERFELD
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 1:253 W SIXTH ST
Mailing Address - Street 2:
Mailing Address - City:MINSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45865
Mailing Address - Country:US
Mailing Address - Phone:419-501-2165
Mailing Address - Fax:419-501-2166
Practice Address - Street 1:253 W SIXTH ST
Practice Address - Street 2:
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865
Practice Address - Country:US
Practice Address - Phone:419-501-2165
Practice Address - Fax:419-501-2166
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01182225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000523169OtherBLUE CROSS BLUE SHIELD
OH232804807OtherRPN
OH1575835OtherFIRST HEALTH/COVENTRY
OH2781431Medicaid
OH1575835OtherFIRST HEALTH/COVENTRY
OH$$$$$$$$$00OtherBWC
OH232804807OtherRPN