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NPI Code Detail

MEDICARE: MS. KATHERINE SATHER NOVAK OTRL

MEDICARE: MS. KATHERINE SATHER NOVAK OTRL
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
1225XP0200XPediatric Occupational Therapist102743MN

General Provider Information

NPI Number : 1518071307
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHERINE SATHER NOVAK OTRL
Provider Business Mailing Address
First Line : 39 LOGAN PKWY NE
Second Line :
City : FRIDLEY
State : MN
Zip : 55432-3038
Country : US
Telephone Number : 612-501-4766
Fax Number :
Provider Business Practice Location Address
First Line : 1250 W BROADWAY AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-2533
Country : US
Telephone Number : 612-517-5756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 11/19/2025

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