Provider Demographics
NPI:1497983183
Name:GARAYANALA, KATHERINE D (RPT)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:D
Last Name:GARAYANALA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3519
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39303-3519
Mailing Address - Country:US
Mailing Address - Phone:601-581-1191
Mailing Address - Fax:601-581-3292
Practice Address - Street 1:1502 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:AL
Practice Address - Zip Code:36744-1552
Practice Address - Country:US
Practice Address - Phone:334-624-3950
Practice Address - Fax:334-624-3960
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1724225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist