Provider Demographics
NPI:1619198009
Name:SMITH, KATHERINE ANN HEBERT (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ANN HEBERT
Last Name:SMITH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:ANN
Other - Last Name:HEBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3 INDUSTRIAL DRIVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087
Mailing Address - Country:US
Mailing Address - Phone:603-870-0078
Mailing Address - Fax:603-870-8134
Practice Address - Street 1:3 INDUSTRIAL DRIVE
Practice Address - Street 2:UNIT 1
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087
Practice Address - Country:US
Practice Address - Phone:603-870-0078
Practice Address - Fax:603-870-8134
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004612225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist