Provider Demographics
NPI:1528815552
Name:DEAN, KATHRYN MICHAELA (OTD, OTR)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MICHAELA
Last Name:DEAN
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 RAINTREE DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-6962
Mailing Address - Country:US
Mailing Address - Phone:940-395-0185
Mailing Address - Fax:
Practice Address - Street 1:272 RAINTREE DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-6962
Practice Address - Country:US
Practice Address - Phone:940-395-0185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123811225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist