Provider Demographics
NPI:1538572532
Name:REYES, KATHERINE GRACE (OTD, OTR/L, CSRS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE GRACE
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:OTD, OTR/L, CSRS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTD, OTR/L, CSRS
Mailing Address - Street 1:11140 ROCKVILLE PIKE STE 100-1206
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3106
Mailing Address - Country:US
Mailing Address - Phone:240-839-1454
Mailing Address - Fax:
Practice Address - Street 1:11140 ROCKVILLE PIKE STE 100-1206
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3106
Practice Address - Country:US
Practice Address - Phone:240-839-1454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2022-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06916225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist