Provider Demographics
NPI:1548928872
Name:EASTER, KATE (OTR/L)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:EASTER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:KOCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:312 STEPPING STONE WAY
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-8388
Mailing Address - Country:US
Mailing Address - Phone:573-803-3338
Mailing Address - Fax:844-579-0089
Practice Address - Street 1:2137 WILLIAM STREET
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5817
Practice Address - Country:US
Practice Address - Phone:573-803-3338
Practice Address - Fax:844-579-0089
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009026806225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist