Provider Demographics
NPI:1215442488
Name:FIELDS, KATHERINE EMILY (OTR/L)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:EMILY
Last Name:FIELDS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:283 CINNABAR LN
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5728
Mailing Address - Country:US
Mailing Address - Phone:267-983-8989
Mailing Address - Fax:
Practice Address - Street 1:1020 KINGS HWY N STE 108
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1906
Practice Address - Country:US
Practice Address - Phone:267-983-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-09
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00804800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist