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General NPI Number Information
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NPI Number | 1447564901
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Entity Type | Individual
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Provider Name | KATHLEEN BYRAM
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Gender | Female
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 1000 1ST DR NW
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City | AUSTIN
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State | MN
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Zip | 55912-2941
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Country | US
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Telephone | 507-434-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 711 4TH ST NW
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City | AUSTIN
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State | MN
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Zip | 55912-3044
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Country | US
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Telephone |
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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 | 100346
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License Number State | MN
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