Provider Demographics
NPI:1891968533
Name:KATTERHAGEN, DIANE Z
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:Z
Last Name:KATTERHAGEN
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 1:46-310 HOAUNA ST
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-4124
Mailing Address - Country:US
Mailing Address - Phone:808-247-2472
Mailing Address - Fax:808-923-2420
Practice Address - Street 1:46-310 HOAUNA ST
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-4124
Practice Address - Country:US
Practice Address - Phone:808-247-2472
Practice Address - Fax:808-923-2420
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT-629225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist