Provider Demographics
NPI:1225414303
Name:GRAY, KATHARINE (ATC, LAT)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GEORGETOWN UNIVERSITY
Mailing Address - Street 2:YATES FIELD HOUSE - 37 AND O STREETS
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20057-0001
Mailing Address - Country:US
Mailing Address - Phone:732-859-6940
Mailing Address - Fax:
Practice Address - Street 1:GEORGETOWN UNIVERSITY
Practice Address - Street 2:YATES FIELD HOUSE - 37 AND O STREETS
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20057-0001
Practice Address - Country:US
Practice Address - Phone:732-859-6940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260015922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer