Provider Demographics
NPI:1710590435
Name:MANDLEHR, KATHERYN ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHERYN
Middle Name:ELIZABETH
Last Name:MANDLEHR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 LAUDERDALE RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1822
Mailing Address - Country:US
Mailing Address - Phone:502-298-5790
Mailing Address - Fax:
Practice Address - Street 1:2206 SPEDALE CT STE 5
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-6138
Practice Address - Country:US
Practice Address - Phone:615-302-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6560225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty