Provider Demographics
NPI:1023268091
Name:MACINTYRE, KATHLEEN HARWELL (ATR-BC, LCAT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:HARWELL
Last Name:MACINTYRE
Suffix:
Gender:F
Credentials:ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-2735
Mailing Address - Country:US
Mailing Address - Phone:718-267-0568
Mailing Address - Fax:
Practice Address - Street 1:291 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2735
Practice Address - Country:US
Practice Address - Phone:718-267-0568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001271221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist