Provider Demographics
NPI:1649546706
Name:ESTEP, KATHRYN JOANNE (LMT)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:JOANNE
Last Name:ESTEP
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:KATHRYN
Other - Middle Name:JOANNE
Other - Last Name:MICHAELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:716 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-2582
Mailing Address - Country:US
Mailing Address - Phone:419-443-8877
Mailing Address - Fax:
Practice Address - Street 1:716 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2582
Practice Address - Country:US
Practice Address - Phone:419-443-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH018514225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist