Healthcare Provider Details

I. General information

NPI: 1982168753
Provider Name (Legal Business Name): KATHRYN CHARRON BEHRHORST OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE CHARRON

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 CASTLEBURY CREEK CT
CARY NC
27519-5629
US

IV. Provider business mailing address

203 CASTLEBURY CREEK CT
CARY NC
27519-5629
US

V. Phone/Fax

Practice location:
  • Phone: 919-749-1626
  • Fax:
Mailing address:
  • Phone: 919-749-1626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number12279
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number12279
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: