Provider Demographics
NPI:1881091544
Name:PRIDE, KATHERINE MARY (DPT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARY
Last Name:PRIDE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1520 SUNDAY DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-5253
Mailing Address - Country:US
Mailing Address - Phone:919-420-1682
Mailing Address - Fax:919-719-3531
Practice Address - Street 1:1520 SUNDAY DR
Practice Address - Street 2:SUITE 105
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5253
Practice Address - Country:US
Practice Address - Phone:919-420-1682
Practice Address - Fax:919-719-3531
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC153002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics