MEDICARE: KATHERINE L BURNETT OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	3719	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3719	OTHER	SC	PROFESSIONAL BOARD OF OCCUPATIONAL THERAPY

General Provider Information

NPI Number	:	1184932725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE L BURNETT OT

Provider Business Mailing Address
First Line	:	PO BOX 170038
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29301-0020
Country	:	US
Telephone Number	:	864-574-7282
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 WILLOW LN
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29307-1365
Country	:	US
Telephone Number	:	864-641-3125
Fax Number	:	864-514-5739

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2010
Last Update Date	:	05/01/2025

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Directions to “ KATHERINE L BURNETT OT” Practice Location

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