Provider Demographics
NPI:1780014290
Name:FRAILING, KATHERINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:FRAILING
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 1:1426 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-4255
Mailing Address - Country:US
Mailing Address - Phone:269-267-4464
Mailing Address - Fax:
Practice Address - Street 1:7855 CURRIER DR
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-4314
Practice Address - Country:US
Practice Address - Phone:269-323-7748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2239212225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist