Provider Demographics
NPI:1568417335
Name:FRITSCHE, KATHERINE LOUISE (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LOUISE
Last Name:FRITSCHE
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 DOVE RD
Mailing Address - Street 2:
Mailing Address - City:RUFFIN
Mailing Address - State:NC
Mailing Address - Zip Code:27326-8936
Mailing Address - Country:US
Mailing Address - Phone:336-939-3312
Mailing Address - Fax:336-939-7789
Practice Address - Street 1:281 DOVE RD
Practice Address - Street 2:
Practice Address - City:RUFFIN
Practice Address - State:NC
Practice Address - Zip Code:27326-8936
Practice Address - Country:US
Practice Address - Phone:336-939-3312
Practice Address - Fax:336-939-7789
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1835225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1245MOtherBLUE CROSS BLUE SHIELD
NC7301343Medicaid