Provider Demographics
NPI:1689222911
Name:SADLER, KATHERINE ANN (COTA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:SADLER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 9TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:DYERSVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52040-2132
Mailing Address - Country:US
Mailing Address - Phone:563-590-8785
Mailing Address - Fax:
Practice Address - Street 1:3485 WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-1329
Practice Address - Country:US
Practice Address - Phone:563-590-8785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00651224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant