Basic Information
Provider Information
NPI: 1053728949
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LABINE
FirstName: KATIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7000 ATRIUM WAY
Address2: STE 6
City: MOUNT LAUREL
State: NJ
PostalCode: 080543917
CountryCode: US
TelephoneNumber: 6099220864
FaxNumber:  
Practice Location
Address1: 113 ROUTE 73
Address2:  
City: VOORHEES
State: NJ
PostalCode: 080439573
CountryCode: US
TelephoneNumber: 8568093500
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/13/2014
LastUpdateDate: 03/21/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X46TR00647600NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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