Provider Demographics
NPI:1134091622
Name:ORR, MARYKATE (BS,IECE)
Entity type:Individual
Prefix:
First Name:MARYKATE
Middle Name:
Last Name:ORR
Suffix:
Gender:F
Credentials:BS,IECE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 FIRE THORN DR
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-9641
Mailing Address - Country:US
Mailing Address - Phone:714-742-2380
Mailing Address - Fax:
Practice Address - Street 1:3707 FIRE THORN DR
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-9641
Practice Address - Country:US
Practice Address - Phone:714-742-2380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist