Provider Demographics
NPI:1811157142
Name:ECONOMOU, KATHRYN JEAN (OTR/L)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JEAN
Last Name:ECONOMOU
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 1:245 CAHABA VALLEY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2216
Mailing Address - Country:US
Mailing Address - Phone:760-471-2986
Mailing Address - Fax:
Practice Address - Street 1:2004 MAX LUTHER DR
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-3800
Practice Address - Country:US
Practice Address - Phone:760-471-2986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9013225X00000X
AL3241225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist