Provider Demographics
NPI:1619372836
Name:SOLEIL, KATHERINE ELISABETH (OT)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ELISABETH
Last Name:SOLEIL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 PASEO DE PERALTA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1860
Mailing Address - Country:US
Mailing Address - Phone:206-778-3880
Mailing Address - Fax:
Practice Address - Street 1:303 PASEO DE PERALTA
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-1860
Practice Address - Country:US
Practice Address - Phone:505-988-2449
Practice Address - Fax:505-986-6005
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9458225X00000X
UT11552301-4201225X00000X
CO0006275225X00000X
OR306084225X00000X
CA20789225X00000X
NM4240225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist