Kathryn Bauer, OTD, OTR/L

Individual provider Active NPI Occupational Therapist · San Tan Valley, AZ

NPI 1619650033 · NPPES record last updated Aug 11, 2023

Key facts

NPI
1619650033
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OTH-009295 (AZ)
Practice address
677 E Kelsi Ave
San Tan Valley, AZ 85140-4140
Phone
(406) 600-4747
NPI assigned
Aug 11, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTH-009295AZMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTH-009295 AZ Yes

Addresses

Primary practice location

677 E Kelsi Ave
San Tan Valley, AZ 85140-4140

Mailing address

677 E Kelsi Ave
San Tan Valley, AZ 85140-4140

Other providers in San Tan Valley, AZ

All providers in San Tan Valley, AZ · Occupational Therapist in Arizona

Sources for this page

Verify at the official NPI Registry.