Provider Demographics
NPI:1952983900
Name:PITRE, KATRINA L (COTA)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:L
Last Name:PITRE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3008 HILL ST UNIT 103
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2554
Mailing Address - Country:US
Mailing Address - Phone:907-715-7772
Mailing Address - Fax:
Practice Address - Street 1:5432 E NORTHERN LIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4713
Practice Address - Country:US
Practice Address - Phone:907-205-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant