Provider Demographics
NPI:1740602804
Name:MCHALE, KATHLEEN (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:MCHALE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 BAYSHORE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-3259
Mailing Address - Country:US
Mailing Address - Phone:609-898-0677
Mailing Address - Fax:
Practice Address - Street 1:3809 BAYSHORE RD
Practice Address - Street 2:
Practice Address - City:NORTH CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-3259
Practice Address - Country:US
Practice Address - Phone:609-898-0677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09053300224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant