Provider Demographics
NPI:1417251539
Name:PRATT, KATTIE MAE (DPT)
Entity Type:Individual
Prefix:
First Name:KATTIE
Middle Name:MAE
Last Name:PRATT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4301
Mailing Address - Country:US
Mailing Address - Phone:518-793-0891
Mailing Address - Fax:518-793-2936
Practice Address - Street 1:3 HUNTER BROOK LN
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5858
Practice Address - Country:US
Practice Address - Phone:518-793-0891
Practice Address - Fax:518-793-2936
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033398-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist