Provider Demographics
NPI:1790018737
Name:MARAKAS, KATIE D (DPT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:D
Last Name:MARAKAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 GALLERIA AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8137
Mailing Address - Country:US
Mailing Address - Phone:919-570-7746
Mailing Address - Fax:
Practice Address - Street 1:11200 GALLERIA AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8137
Practice Address - Country:US
Practice Address - Phone:919-570-7746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP12343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist