Basic Information
Provider Information
NPI: 1386093813
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHULTE
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: COREA
OtherFirstName: KATHERINE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: OT
OtherLastNameType: 1
Mailing Information
Address1: 90 HOWARD DR
Address2:  
City: SHELBYVILLE
State: KY
PostalCode: 400658138
CountryCode: US
TelephoneNumber: 5026331007
FaxNumber: 5024370624
Practice Location
Address1: 90 HOWARD DR
Address2:  
City: SHELBYVILLE
State: KY
PostalCode: 400658138
CountryCode: US
TelephoneNumber: 5026331007
FaxNumber: 5024370624
Other Information
ProviderEnumerationDate: 06/06/2016
LastUpdateDate: 12/21/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X167242KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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