Provider Demographics
NPI:1811665458
Name:THOMSON, KATELYNN ZANDERS (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:KATELYNN
Middle Name:ZANDERS
Last Name:THOMSON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:KATELYNN
Other - Middle Name:ILYESHA
Other - Last Name:ZANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:17101 SNOWMOBILE LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577
Mailing Address - Country:US
Mailing Address - Phone:907-694-8085
Mailing Address - Fax:
Practice Address - Street 1:17101 SNOWMOBILE LN
Practice Address - Street 2:SUITE 202
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577
Practice Address - Country:US
Practice Address - Phone:907-694-8085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK181907225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist