Provider Demographics
NPI:1710353727
Name:STENSLAND, KATHERINE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:STENSLAND
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 NORTH DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-9216
Mailing Address - Country:US
Mailing Address - Phone:321-254-4254
Mailing Address - Fax:
Practice Address - Street 1:760 NORTH DR
Practice Address - Street 2:SUITE D
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-9216
Practice Address - Country:US
Practice Address - Phone:321-254-4254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 10175225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT10175OtherFL DEPT OF HEALTH