Provider Demographics
NPI:1346733763
Name:HOLBROOK, KATELYN ELAINE (OTD)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:ELAINE
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:ELAINE
Other - Last Name:TODD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1915 PHILADELPHIA STREET
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010
Mailing Address - Country:US
Mailing Address - Phone:515-232-7220
Mailing Address - Fax:515-232-3834
Practice Address - Street 1:1915 PHILADELPHIA STREET
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010
Practice Address - Country:US
Practice Address - Phone:515-232-7220
Practice Address - Fax:515-232-3834
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist