Healthcare Provider Details

I. General information

NPI: 1841126208
Provider Name (Legal Business Name): KATHRYN JOY QUIETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE QUIETT OTR/L

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 GAIL HARRIS ST
ROSWELL NM
88203-8116
US

IV. Provider business mailing address

72 GAIL HARRIS ST
ROSWELL NM
88203-8116
US

V. Phone/Fax

Practice location:
  • Phone: 575-347-3400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT909
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: