Individual
MARY KATHERINE BLATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
12708 RIATA VISTA CIR STE A106, AUSTIN, TX 78727-7174
(304) 815-1116
Mailing address
12708 RIATA VISTA CIR STE A106, AUSTIN, TX 78727-7174
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
121053
TX
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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