Provider Demographics
NPI:1316494941
Name:ROBERTS, KATHRYN (MOTR/L)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 MERIDIAN ROAD
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9605
Mailing Address - Country:US
Mailing Address - Phone:724-443-0700
Mailing Address - Fax:724-444-5577
Practice Address - Street 1:5850 MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9605
Practice Address - Country:US
Practice Address - Phone:724-443-0700
Practice Address - Fax:724-444-5577
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC007139L225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation