Provider Demographics
NPI:1265105019
Name:GARCIA, KATHLEEN JEANETTE (ATR-BC, LPAT)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:JEANETTE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:ATR-BC, LPAT
Other - Prefix:MS
Other - First Name:KATHY
Other - Middle Name:J
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:841 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1014
Mailing Address - Country:US
Mailing Address - Phone:502-561-1051
Mailing Address - Fax:502-561-1089
Practice Address - Street 1:841 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1014
Practice Address - Country:US
Practice Address - Phone:502-561-1051
Practice Address - Fax:502-561-1089
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272086221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist