MEDICARE: THERAPY BY KATEY LLC

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	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1427447655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY BY KATEY LLC

Provider Business Mailing Address
First Line	:	3025 HASWELL ST
Second Line	:	APT 1515
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-6414
Country	:	US
Telephone Number	:	843-312-7625
Fax Number	:

Provider Business Practice Location Address
First Line	:	3025 HASWELL ST
Second Line	:	APT 1515
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-6414
Country	:	US
Telephone Number	:	843-312-7625
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	KATHLEEN CAUSEY
Credential	:	OTR/L
Telephone Number	:	843-312-7625

Provider Enumeration Date	:	01/12/2015
Last Update Date	:	01/13/2015

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