Healthcare Provider Details

I. General information

NPI: 1417254103
Provider Name (Legal Business Name): KATHERINE ELIZABETH GEBHART OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2011
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W ANDERSON LN STE C100
AUSTIN TX
78752-1119
US

IV. Provider business mailing address

PO BOX 15024
AUSTIN TX
78761-5024
US

V. Phone/Fax

Practice location:
  • Phone: 512-451-0961
  • Fax: 512-451-9745
Mailing address:
  • Phone: 512-451-0961
  • Fax: 512-451-9745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number114001
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: