Provider Demographics
NPI:1396210001
Name:WALSH, KATHRYN (OT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WALSH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:MEYERHOFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1177 MONETA AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-9591
Mailing Address - Country:US
Mailing Address - Phone:440-537-4465
Mailing Address - Fax:
Practice Address - Street 1:5277 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-4334
Practice Address - Country:US
Practice Address - Phone:440-557-1186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT009724225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist