Provider Demographics
NPI:1831808583
Name:MCCUTCHEON, KATELYN JANE (COTA, LMT)
Entity type:Individual
Prefix:MISS
First Name:KATELYN
Middle Name:JANE
Last Name:MCCUTCHEON
Suffix:
Gender:F
Credentials:COTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 CONNECTICUT AVE NW STE 417
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5458
Mailing Address - Country:US
Mailing Address - Phone:202-528-7223
Mailing Address - Fax:
Practice Address - Street 1:1025 CONNECTICUT AVE NW STE 417
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5458
Practice Address - Country:US
Practice Address - Phone:202-528-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOTA200001246224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant