Healthcare Provider Details

I. General information

NPI: 1588909469
Provider Name (Legal Business Name): KATELYN HEGARTY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2012
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 W SAHARA AVE
LAS VEGAS NV
89146-0842
US

IV. Provider business mailing address

991 PERFECT BERM LN
HENDERSON NV
89002-3317
US

V. Phone/Fax

Practice location:
  • Phone: 725-502-0307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-3188
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: