Provider Demographics
NPI:1073228227
Name:PRATT, GRACE (OTR)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:PRATT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:GOERNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2105 ERIE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-3215
Mailing Address - Country:US
Mailing Address - Phone:157-373-9583
Mailing Address - Fax:
Practice Address - Street 1:1445 KEMBLE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-4441
Practice Address - Country:US
Practice Address - Phone:315-737-3958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist