Provider Demographics
NPI:1962828061
Name:WARD, KATE
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 KNOWLTON AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217
Mailing Address - Country:US
Mailing Address - Phone:716-481-7882
Mailing Address - Fax:
Practice Address - Street 1:172 OLD STATE RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND FALLS
Practice Address - State:NY
Practice Address - Zip Code:10928-4304
Practice Address - Country:US
Practice Address - Phone:716-481-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-13
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0200X, 225X00000X
NY018646252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No252Y00000XAgenciesEarly Intervention Provider Agency