Provider Demographics
NPI:1245525559
Name:RICHARDSON, KATHRYN ANNE (MS, AT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANNE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:MS, AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 HARTNEY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1615
Mailing Address - Country:US
Mailing Address - Phone:440-655-6566
Mailing Address - Fax:
Practice Address - Street 1:3430 OHIOHEALTH PARKWAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202
Practice Address - Country:US
Practice Address - Phone:440-655-6566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0047202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer