Individual
KATHERINE ELLIOTT BLANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
849 MENLO AVE, MENLO PARK, CA 94025-4728
(650) 323-0805
Mailing address
216 MARMONA DR, MENLO PARK, CA 94025-2914
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT18125
CA
Other
Enumeration date
01/10/2018
Last updated
01/10/2018
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