Provider Demographics
NPI:1306050885
Name:MEADE, KATHLEEN MARY (OTRL)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARY
Last Name:MEADE
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 GREAT BARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01266-9216
Mailing Address - Country:US
Mailing Address - Phone:413-717-5864
Mailing Address - Fax:
Practice Address - Street 1:107 GREAT BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:WEST STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01266-9216
Practice Address - Country:US
Practice Address - Phone:413-717-5864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist