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General NPI Number Information
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NPI Number | 1093104267
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Entity Type | Individual
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Provider Name | KATHERINE CORCORAN WALTER
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Gender | Female
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Dates
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Enumeration Date | 01/12/2015
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 837 CHIEF EDDIE HOFFMAN HWY
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City | BETHEL
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State | AK
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Zip | 99559
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Country | US
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Telephone | 907-543-3690
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Fax | 907-543-1276
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Provider Business Mailing Address
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Address Line | PO BOX 200
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City | DAYTON
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State | MT
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Zip | 59914-0200
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Country | US
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Telephone | 406-206-5692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTPOTLIC3346
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2086
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT2331
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 103447
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License Number State | AK
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