Provider Demographics
NPI:1356655385
Name:DENNIS, KATY E (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KATY
Middle Name:E
Last Name:DENNIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:KATY
Other - Middle Name:E
Other - Last Name:BISCHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5120 WILLIAMSON ON THE LK
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:NY
Mailing Address - Zip Code:14589-9758
Mailing Address - Country:US
Mailing Address - Phone:585-455-9942
Mailing Address - Fax:
Practice Address - Street 1:5120 WILLIAMSON ON THE LK
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:NY
Practice Address - Zip Code:14589-9758
Practice Address - Country:US
Practice Address - Phone:585-455-9942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016269-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist