Provider Demographics
NPI:1063552131
Name:DOS SANTOS, KATHERINE ANN (OTR)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:DOS SANTOS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6965 RENO CIR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77708-3594
Mailing Address - Country:US
Mailing Address - Phone:516-551-5383
Mailing Address - Fax:
Practice Address - Street 1:1020 S 23RD ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-4202
Practice Address - Country:US
Practice Address - Phone:409-842-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0144401225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics