Provider Demographics
NPI:1013620251
Name:TOWLERTON, KATELYNNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATELYNNE
Middle Name:
Last Name:TOWLERTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 E SHAULIS RD
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-4722
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 5TH ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:IA
Practice Address - Zip Code:50643-7776
Practice Address - Country:US
Practice Address - Phone:319-239-1062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA099528225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist