Provider Demographics
NPI:1538464383
Name:O'BRIAN, KATIE E (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:E
Last Name:O'BRIAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:VT
Mailing Address - Zip Code:05354-9611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:86 WOODLAND RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:VT
Practice Address - Zip Code:05354-9611
Practice Address - Country:US
Practice Address - Phone:802-579-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072.0000565225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist