Provider Demographics
NPI:1578820205
Name:BIRI, KATHLEEN A (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:A
Last Name:BIRI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 N MT AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-9998
Mailing Address - Country:US
Mailing Address - Phone:573-335-7868
Mailing Address - Fax:573-335-8193
Practice Address - Street 1:1405 N MT AUBURN RD
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-9998
Practice Address - Country:US
Practice Address - Phone:573-335-7868
Practice Address - Fax:573-335-8193
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2413225100000X
MO2015039231225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist