Provider Demographics
NPI:1790211001
Name:LOVEDAY, KATHRYN MONIQUE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MONIQUE
Last Name:LOVEDAY
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1846 TUCSON DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2744
Mailing Address - Country:US
Mailing Address - Phone:972-983-2682
Mailing Address - Fax:
Practice Address - Street 1:1846 TUCSON DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2744
Practice Address - Country:US
Practice Address - Phone:972-983-2682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT67132255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer