Healthcare Provider Details

I. General information

NPI: 1851403133
Provider Name (Legal Business Name): KATHERINE JANE KELLOGG OT/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE JANE HILL OT/L

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 ALVORD PARK RD
TORRINGTON CT
06790-3493
US

IV. Provider business mailing address

174 S MOUNTAIN DR
NEW BRITAIN CT
06052-1514
US

V. Phone/Fax

Practice location:
  • Phone: 860-482-8539
  • Fax:
Mailing address:
  • Phone: 618-616-9009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number0022556
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number002556
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: