Provider Demographics
NPI:1366621658
Name:WHIPPLE, KATHRYN HUGHES (OT/R)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:HUGHES
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:OT/R
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:ELIZABETH
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-1238
Mailing Address - Country:US
Mailing Address - Phone:315-331-7741
Mailing Address - Fax:315-331-0566
Practice Address - Street 1:215 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411-1513
Practice Address - Country:US
Practice Address - Phone:585-589-0771
Practice Address - Fax:315-331-0566
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011332225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist