MEDICARE: CATHERINE K BIRCHFIELD O.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	R0305	KY

General Provider Information

NPI Number	:	1063891463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE K BIRCHFIELD O.T.

Provider Business Mailing Address
First Line	:	5203 OLDE CREEK WAY
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-9667
Country	:	US
Telephone Number	:	502-548-4103
Fax Number	:

Provider Business Practice Location Address
First Line	:	5203 OLDE CREEK WAY
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-9667
Country	:	US
Telephone Number	:	502-548-4103
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2015
Last Update Date	:	05/19/2015

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