Provider Demographics
NPI:1639189988
Name:SNELGROVE, KATHLEEN E (OTR/CHT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:SNELGROVE
Suffix:
Gender:F
Credentials:OTR/CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DUDLEY ST
Mailing Address - Street 2:SUITE200
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3236
Mailing Address - Country:US
Mailing Address - Phone:401-457-1580
Mailing Address - Fax:401-831-0500
Practice Address - Street 1:2 DUDLEY ST
Practice Address - Street 2:SUITE200
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3236
Practice Address - Country:US
Practice Address - Phone:401-457-1580
Practice Address - Fax:401-831-0500
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT00481225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007006796Medicare ID - Type Unspecified