Provider Demographics
NPI:1124426028
Name:FIELDER, KATHY (COTA)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:
Last Name:FIELDER
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 1:866 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-9427
Mailing Address - Country:US
Mailing Address - Phone:740-708-0072
Mailing Address - Fax:
Practice Address - Street 1:11268 COUNTY ROAD 550
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9789
Practice Address - Country:US
Practice Address - Phone:740-773-8044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.02144224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant