Provider Demographics
NPI:1194924027
Name:BELLAMY, KATHRYN NICOLE (COTA/L)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:NICOLE
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1196 1ST STREET EXT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-9239
Mailing Address - Country:US
Mailing Address - Phone:252-903-5760
Mailing Address - Fax:
Practice Address - Street 1:1196 1ST STREET EXT
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-9239
Practice Address - Country:US
Practice Address - Phone:252-903-5760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4268224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant