Provider Demographics
NPI:1568650646
Name:BURHANS, KATHLEEN SUE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:SUE
Last Name:BURHANS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 E 62ND ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4322
Mailing Address - Country:US
Mailing Address - Phone:912-484-2143
Mailing Address - Fax:
Practice Address - Street 1:407 E 62ND ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4322
Practice Address - Country:US
Practice Address - Phone:912-484-2143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-14
Last Update Date:2007-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1980225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist