Provider Demographics
NPI:1316144959
Name:PRESCOTT, KATHERINE ANN (ATC, LAT)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANN
Last Name:PRESCOTT
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 1:831 SPRING CIR
Mailing Address - Street 2:APT. #203
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-8106
Mailing Address - Country:US
Mailing Address - Phone:954-571-1650
Mailing Address - Fax:
Practice Address - Street 1:3900 JOG RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4455
Practice Address - Country:US
Practice Address - Phone:561-210-2203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 18142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer