Provider Demographics
NPI:1457539066
Name:HORNSBY, KATRINA DEANNE (OTR)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:DEANNE
Last Name:HORNSBY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:DEANNE
Other - Last Name:THRASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:100 E FERGUSON ST STE 1204
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-5700
Mailing Address - Country:US
Mailing Address - Phone:903-509-2040
Mailing Address - Fax:
Practice Address - Street 1:100 E FERGUSON ST STE 1204
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-5700
Practice Address - Country:US
Practice Address - Phone:903-509-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109435225X00000X
AROTR1489225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist