Healthcare Provider Details

I. General information

NPI: 1518523323
Provider Name (Legal Business Name): KATIE A RICHTER MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 W MAIN ST
FREEHOLD NJ
07728-2538
US

IV. Provider business mailing address

1043 W MAIN ST
FREEHOLD NJ
07728-2538
US

V. Phone/Fax

Practice location:
  • Phone: 732-800-9000
  • Fax: 732-840-2088
Mailing address:
  • Phone: 732-800-9000
  • Fax: 732-840-2088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number023569
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR00873700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: