Basic Information
Provider Information
NPI: 1639625502
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAJOT
FirstName: KATHERINE
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 90 HOWARD DR
Address2:  
City: SHELBYVILLE
State: KY
PostalCode: 400658138
CountryCode: US
TelephoneNumber: 5026331007
FaxNumber: 5028051511
Practice Location
Address1: 1405 E BURNETT AVE
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402171577
CountryCode: US
TelephoneNumber: 5025880736
FaxNumber: 5025880721
Other Information
ProviderEnumerationDate: 08/30/2016
LastUpdateDate: 12/29/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X165482KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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