Provider Demographics
NPI:1689136996
Name:KATSAROU, LINNEA DAFNE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:LINNEA
Middle Name:DAFNE
Last Name:KATSAROU
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 TEMPLETON GAP DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-3918
Mailing Address - Country:US
Mailing Address - Phone:919-491-4043
Mailing Address - Fax:
Practice Address - Street 1:1601 E MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27411-0002
Practice Address - Country:US
Practice Address - Phone:336-398-8672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-38852255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer