Provider Demographics
NPI:1477757698
Name:SKARO, KATIE MARIE (MS OTRL)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:MARIE
Last Name:SKARO
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:MISS
Other - First Name:KATIE
Other - Middle Name:MARIE
Other - Last Name:SKARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTRL
Mailing Address - Street 1:4510 COVEY LANE
Mailing Address - Street 2:
Mailing Address - City:MINNETRISTA
Mailing Address - State:MN
Mailing Address - Zip Code:55375
Mailing Address - Country:US
Mailing Address - Phone:952-446-8192
Mailing Address - Fax:
Practice Address - Street 1:1772 STIEGER LAKE LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:VICTORIA
Practice Address - State:MN
Practice Address - Zip Code:55386
Practice Address - Country:US
Practice Address - Phone:952-443-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102829225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics