Provider Demographics
NPI:1558073288
Name:SPAHN, KATELYN R (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:R
Last Name:SPAHN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:KATELYN
Other - Middle Name:R
Other - Last Name:MULQUEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:82 LIVINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-2408
Mailing Address - Country:US
Mailing Address - Phone:914-572-5638
Mailing Address - Fax:
Practice Address - Street 1:50 ICHABOD LN
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-3715
Practice Address - Country:US
Practice Address - Phone:914-366-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024550225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist