Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | C2228 | WV |
N | 224Z00000X | Occupational Therapy Assistant | OTA007345 | OH |
NPI | 1013567593 |
---|---|
Provider Name | Kate Leann Baters |
First Address | Morgantown, WV 26505-7345 |
Second Address | Morgantown, WV 26505-3415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2019 |
Last Update Date | 16/09/2019 |