Provider Demographics
NPI:1255544318
Name:DECLEENE, KATE ELIZABETH (OTD, MS, OTR)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:ELIZABETH
Last Name:DECLEENE
Suffix:
Gender:F
Credentials:OTD, MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7494 CHARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-9682
Mailing Address - Country:US
Mailing Address - Phone:317-328-5242
Mailing Address - Fax:317-788-3542
Practice Address - Street 1:5905 S EMERSON AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-2402
Practice Address - Country:US
Practice Address - Phone:317-782-8888
Practice Address - Fax:317-788-4640
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003710A174400000X
WIOT174400000X
CAOT174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist