MEDICARE: KATIE PEAT OTR

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	31001666A	IN

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	200555	OTHER	IN	CSHS PROVIDER NUMBER

General Provider Information

NPI Number	:	1952462459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE PEAT OTR

Provider Business Mailing Address
First Line	:	2521 E MARKET ST
Second Line	:	SUITE A
City	:	NAPPANEE
State	:	IN
Zip	:	46550-9396
Country	:	US
Telephone Number	:	574-773-7733
Fax Number	:	574-773-7133

Provider Business Practice Location Address
First Line	:	2521 E MARKET ST
Second Line	:	SUITE A
City	:	NAPPANEE
State	:	IN
Zip	:	46550-9396
Country	:	US
Telephone Number	:	574-773-7733
Fax Number	:	574-773-7133

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	04/29/2014

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Directions to “ KATIE PEAT OTR” Practice Location

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