Provider Demographics
NPI:1407288178
Name:TRAPP, KATERI ELISE (PT)
Entity Type:Individual
Prefix:DR
First Name:KATERI
Middle Name:ELISE
Last Name:TRAPP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:DR
Other - First Name:KATERI
Other - Middle Name:ELISE
Other - Last Name:BOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4400 LINDELL BLVD
Mailing Address - Street 2:UNIT 11K
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2452
Mailing Address - Country:US
Mailing Address - Phone:319-939-1664
Mailing Address - Fax:
Practice Address - Street 1:12608 LAMPLIGHTER SQUARE SHPG CTR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2746
Practice Address - Country:US
Practice Address - Phone:314-842-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013025000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist