Provider Demographics
NPI:1780764795
Name:PITT, KATHLEEN ANN (DSC, OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:PITT
Suffix:
Gender:F
Credentials:DSC, OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12508 JONES MALTSBERGER RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-4215
Mailing Address - Country:US
Mailing Address - Phone:885-904-0028
Mailing Address - Fax:210-590-4585
Practice Address - Street 1:11601 W HWY 290 STE A-102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737
Practice Address - Country:US
Practice Address - Phone:737-300-9980
Practice Address - Fax:737-300-9981
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1072788225XH1200X
TX1277971225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand