Provider Demographics
NPI:1568969384
Name:MORRIS, KATELYN SUZANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:SUZANNE
Last Name:MORRIS
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 1:9986 COUNTY ROAD 120
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-5177
Mailing Address - Country:US
Mailing Address - Phone:417-388-0635
Mailing Address - Fax:
Practice Address - Street 1:1000 W POPLAR ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-4242
Practice Address - Country:US
Practice Address - Phone:479-631-7678
Practice Address - Fax:479-631-8886
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3145225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist