Provider Demographics
NPI:1770238081
Name:ZELLER, CATHERINE MARIE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:ZELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:MARIE
Other - Last Name:HELTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4921 E 21ST ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-1602
Mailing Address - Country:US
Mailing Address - Phone:316-681-3204
Mailing Address - Fax:
Practice Address - Street 1:4921 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-1602
Practice Address - Country:US
Practice Address - Phone:316-681-3204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-03917225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist