Provider Demographics
NPI:1770053381
Name:COENEN, KATIE D (OT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:D
Last Name:COENEN
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:DIANE
Other - Last Name:OKAMOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 NEENAH CTR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3070
Mailing Address - Country:US
Mailing Address - Phone:920-830-5900
Mailing Address - Fax:920-830-5910
Practice Address - Street 1:130 2ND ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2883
Practice Address - Country:US
Practice Address - Phone:920-729-2155
Practice Address - Fax:920-720-7350
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6400-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist