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General NPI Number Information
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NPI Number | 1992336994
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Entity Type | Individual
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Provider Name | KATHERINE A TILLEY PHD, OTR/L, CLT
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Gender | Female
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 634 SW MULVANE ST STE 404
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City | TOPEKA
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State | KS
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Zip | 66606-1678
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Country | US
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Telephone | 785-295-8045
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 SUNDANCE DR
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City | MANHATTAN
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State | KS
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Zip | 66503-8616
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Country | US
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Telephone | 785-565-4169
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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 | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number |
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License Number State |
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