Healthcare Provider Details

I. General information

NPI: 1003750936
Provider Name (Legal Business Name): KATIE HIRD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8108 FANFAIR LN
PASADENA MD
21122-3878
US

IV. Provider business mailing address

8108 FANFAIR LN
PASADENA MD
21122-3878
US

V. Phone/Fax

Practice location:
  • Phone: 520-247-5255
  • Fax:
Mailing address:
  • Phone: 520-247-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KATELYN HIRD
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTD,OTR/L
Phone: 520-247-5255