Provider Demographics
NPI:1952446874
Name:HARVATH, KATHERINE ELAINE (DPT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELAINE
Last Name:HARVATH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ELAINE
Other - Last Name:TEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 STRATFORD LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1628
Mailing Address - Country:US
Mailing Address - Phone:314-856-3403
Mailing Address - Fax:
Practice Address - Street 1:641 N NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6713
Practice Address - Country:US
Practice Address - Phone:314-872-3345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005028009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist