Provider Demographics
NPI:1548699879
Name:MITCHELL, KATHRYN LYNN (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:LYNN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:MILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:1421 PINE RIDGE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2116
Mailing Address - Country:US
Mailing Address - Phone:239-597-0935
Mailing Address - Fax:239-610-1462
Practice Address - Street 1:1421 PINE RIDGE RD STE 120
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2116
Practice Address - Country:US
Practice Address - Phone:239-597-0935
Practice Address - Fax:239-610-1462
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 16013225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics