Provider Demographics
NPI:1396458741
Name:MUHLBAIER, KATIE
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:MUHLBAIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 CROW POND RD
Mailing Address - Street 2:
Mailing Address - City:PITTSGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-4106
Mailing Address - Country:US
Mailing Address - Phone:856-472-1671
Mailing Address - Fax:
Practice Address - Street 1:801 RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-1744
Practice Address - Country:US
Practice Address - Phone:610-825-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01085200225X00000X
PAOC018952225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist