Provider Demographics
NPI:1972659738
Name:THOMAS, KATHY (OTR L)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:THOMAS
Other - Last Name:ELWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3122 RED LAWN DR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-1835
Mailing Address - Country:US
Mailing Address - Phone:610-867-3827
Mailing Address - Fax:
Practice Address - Street 1:336 W SPRUCE ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-3739
Practice Address - Country:US
Practice Address - Phone:610-867-3827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000673L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist