Provider Demographics
NPI:1386976801
Name:KLAMERT, KATHRYN SUE (OTR, CHT)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:SUE
Last Name:KLAMERT
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12194 NEFF ROAD
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420
Mailing Address - Country:US
Mailing Address - Phone:810-287-9737
Mailing Address - Fax:810-687-2799
Practice Address - Street 1:12194 NEFF ROAD
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420
Practice Address - Country:US
Practice Address - Phone:810-287-9737
Practice Address - Fax:810-687-2799
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI520100183225XH1200X
MI5201001813225XN1300X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation