MEDICARE: KATELYN HEGARTY OTR/L

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	OT-3188	NV

General Provider Information

NPI Number	:	1588909469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN HEGARTY OTR/L

Provider Business Mailing Address
First Line	:	991 PERFECT BERM LN
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89002-3317
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6655 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0842
Country	:	US
Telephone Number	:	725-502-0307
Fax Number	:

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

Provider Enumeration Date	:	12/04/2012
Last Update Date	:	12/14/2025

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