Provider Demographics
NPI:1780894980
Name:FRAHM, KATHLEEN BERNADETTE (OT)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:BERNADETTE
Last Name:FRAHM
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9434 MADISON PL APT 913
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-6500
Mailing Address - Country:US
Mailing Address - Phone:786-393-7807
Mailing Address - Fax:
Practice Address - Street 1:9434 MADISON PL APT 913
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-6500
Practice Address - Country:US
Practice Address - Phone:786-393-7807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0005978225X00000X
IN31006878A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist