Basic Information
| Provider Information | |||||||||
| NPI: | 1770754947 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ST. PIERRE | ||||||||
| FirstName: | KATIE | ||||||||
| MiddleName: | KYRITZ | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OTR/L | ||||||||
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| OtherOrganizationType: | |||||||||
| OtherLastName: | SPAULDING | ||||||||
| OtherFirstName: | KATIE | ||||||||
| OtherMiddleName: | KYRITZ | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 243 DELANO RD | ||||||||
| Address2: | |||||||||
| City: | TICONDEROGA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128832918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182220394 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 127 CAMBRIDGE ST STE 2B | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812722536 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2008 | ||||||||
| LastUpdateDate: | 07/31/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 825 | HI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.