Provider Demographics
NPI:1427144302
Name:ALLEN, KATHRYN L (OTR L)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:L
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LEIGH
Other - Last Name:FARROW ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2197 W RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:ME
Mailing Address - Zip Code:04330-2708
Mailing Address - Country:US
Mailing Address - Phone:207-547-3644
Mailing Address - Fax:
Practice Address - Street 1:TOGUS VAMROC
Practice Address - Street 2:OT 126T IVA CENTER
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT353225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist