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General NPI Number Information
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NPI Number | 1609738152
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Entity Type | Individual
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Provider Name | KATIE A BULL OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 390 NORTH LOOP RD
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City | FORT IRWIN
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State | CA
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Zip | 92310
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Country | US
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Telephone | 866-957-9224
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Fax |
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Provider Business Mailing Address
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Address Line | 8614 RHINELAND DR APT A
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City | FORT IRWIN
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State | CA
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Zip | 92310-2611
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Country | US
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Telephone | 254-495-4505
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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 | OT.0009060
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License Number State | CO
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