Provider Demographics
NPI:1376995209
Name:ALLEN, KATELYN (OTD)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 NE MCCLAIN RD STE 137
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3875
Mailing Address - Country:US
Mailing Address - Phone:479-407-4523
Mailing Address - Fax:855-731-1394
Practice Address - Street 1:1202 NE MCCLAIN RD STE 137
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3875
Practice Address - Country:US
Practice Address - Phone:479-407-4523
Practice Address - Fax:855-731-1394
Is Sole Proprietor?:No
Enumeration Date:2016-07-03
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist