Provider Demographics
NPI:1659570117
Name:ANTIN-MCCARTY, KATEE SUMMER (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATEE
Middle Name:SUMMER
Last Name:ANTIN-MCCARTY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KATEE
Other - Middle Name:
Other - Last Name:MCCARTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5649 DEVONSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2872
Mailing Address - Country:US
Mailing Address - Phone:314-302-7073
Mailing Address - Fax:
Practice Address - Street 1:5649 DEVONSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2872
Practice Address - Country:US
Practice Address - Phone:314-302-7073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001016607225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist