Provider Demographics
NPI:1427603547
Name:GROAT, KATHERINE MOORE
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MOORE
Last Name:GROAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7833 GALILEO WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-1873
Mailing Address - Country:US
Mailing Address - Phone:669-224-2066
Mailing Address - Fax:
Practice Address - Street 1:7833 GALILEO WAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80125-1873
Practice Address - Country:US
Practice Address - Phone:669-224-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006039225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist