Provider Demographics
NPI:1720190192
Name:MCDERMOND, KATHRYN JANE (OTR)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:JANE
Last Name:MCDERMOND
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7109 CHARLES SPRING WAY
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-3735
Mailing Address - Country:US
Mailing Address - Phone:917-880-6987
Mailing Address - Fax:
Practice Address - Street 1:1 OLYMPIC PL STE 200
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4118
Practice Address - Country:US
Practice Address - Phone:410-704-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012385-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist