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General NPI Number Information
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NPI Number | 1851377782
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Entity Type | Individual
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Provider Name | KATHERINE V ST. PERE OTR
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Gender | Female
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 08/21/2017
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Provider Practice Location Address
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Address Line | 14020 OLD STATE RD STE D100
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City | EVANSVILLE
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State | IN
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Zip | 47725-1167
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Country | US
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Telephone | 812-474-7769
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Fax |
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Provider Business Mailing Address
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Address Line | 5927 RELIABLE PWY
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City | CHICAGO
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State | IL
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Zip | 60686-0001
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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 | 31003186A
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License Number State | IN
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