Provider Demographics
NPI:1699390781
Name:MORRISSEY, KATRINA (OTR/L)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:LOUISE
Other - Last Name:VETO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1722 N NEWCASTLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4422
Mailing Address - Country:US
Mailing Address - Phone:773-458-4448
Mailing Address - Fax:
Practice Address - Street 1:1722 N NEWCASTLE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-4422
Practice Address - Country:US
Practice Address - Phone:773-458-4448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
056008714225X00000X
IL056008714225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist