Provider Demographics
NPI:1730368028
Name:KATHLEEN D. SHAFFER LLC
Entity type:Organization
Organization Name:KATHLEEN D. SHAFFER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:DUKE
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:512-251-3230
Mailing Address - Street 1:2415 W PECAN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3670
Mailing Address - Country:US
Mailing Address - Phone:512-251-3230
Mailing Address - Fax:512-251-8760
Practice Address - Street 1:2415 W PECAN ST STE 100
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3670
Practice Address - Country:US
Practice Address - Phone:512-251-3230
Practice Address - Fax:512-251-8760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty