Provider Demographics
NPI:1104466390
Name:GRESS, KATLYN (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:GRESS
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 SW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1995
Mailing Address - Country:US
Mailing Address - Phone:785-249-5541
Mailing Address - Fax:785-272-7912
Practice Address - Street 1:3500 SW 10TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1995
Practice Address - Country:US
Practice Address - Phone:785-249-5541
Practice Address - Fax:785-272-7912
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-03574225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics