Provider Demographics
NPI:1205526738
Name:PUCKETT, KATIE COX (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:COX
Last Name:PUCKETT
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 1:2709 HEATHER PL
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36804-7825
Mailing Address - Country:US
Mailing Address - Phone:334-538-4917
Mailing Address - Fax:
Practice Address - Street 1:704 AVENUE D
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-4962
Practice Address - Country:US
Practice Address - Phone:334-610-0033
Practice Address - Fax:844-955-2544
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4212225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist