Individual
KATHLEEN BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5535 S WILLIAMSON BLVD, STE 774, PORT ORANGE, FL 32128-8311
(800) 330-7711
Mailing address
212 W BROADMOOR ST, SPRINGFIELD, MO 65807-2933
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2006023063
MO
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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