Healthcare Provider Details

I. General information

NPI: 1588546618
Provider Name (Legal Business Name): KATHERINA ZUMALT OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6984 PINE FOREST RD
PENSACOLA FL
32526-8908
US

IV. Provider business mailing address

300 W MAIN ST
WALNUT GROVE MO
65770-7305
US

V. Phone/Fax

Practice location:
  • Phone: 850-430-3400
  • Fax:
Mailing address:
  • Phone: 417-324-1039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number26275
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: