Provider Demographics
NPI:1669617494
Name:INSLEY, KATHRYN MARY
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARY
Last Name:INSLEY
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 1:11107 S DEERPATH LN
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-2104
Mailing Address - Country:US
Mailing Address - Phone:708-514-1272
Mailing Address - Fax:
Practice Address - Street 1:11107 S DEERPATH LN
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-2104
Practice Address - Country:US
Practice Address - Phone:708-514-1272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist