Provider Demographics
NPI:1881011450
Name:FLETCHER, KATIE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:WOOLARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:3905 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2517
Mailing Address - Country:US
Mailing Address - Phone:919-928-0204
Mailing Address - Fax:
Practice Address - Street 1:3905 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2517
Practice Address - Country:US
Practice Address - Phone:919-928-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9055225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics