Provider Demographics
NPI:1407370968
Name:WELLMAN, KATHRYN MCKENZIE
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MCKENZIE
Last Name:WELLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 WINTER AVE
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-1941
Mailing Address - Country:US
Mailing Address - Phone:774-218-3636
Mailing Address - Fax:
Practice Address - Street 1:18 WINTER AVE
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-1941
Practice Address - Country:US
Practice Address - Phone:774-218-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant