Provider Demographics
NPI:1184373086
Name:BALL, KATELYN (OTR/L)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:BALL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:
Other - Last Name:BROOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:241 TRAVERSE BLVD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1015
Mailing Address - Country:US
Mailing Address - Phone:716-499-7432
Mailing Address - Fax:
Practice Address - Street 1:3767 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1040
Practice Address - Country:US
Practice Address - Phone:716-499-7432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics