Provider Demographics
NPI:1427504240
Name:COLEGATE, KARLA (OTR/L)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:COLEGATE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 CHERRY BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-9434
Mailing Address - Country:US
Mailing Address - Phone:513-967-4403
Mailing Address - Fax:
Practice Address - Street 1:5425 CHERRY BLOSSOM CT
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-9434
Practice Address - Country:US
Practice Address - Phone:513-967-4403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT. 3245225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist