Individual
KATIE ELIZABETH MOUATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
626 MAPLE HILL DR, KALAMAZOO, MI 49009-1032
(269) 544-2901
(269) 344-9919
Mailing address
626 MAPLE HILL DRIVE, KALAMAZOO, MI 49009
(269) 544-2901
(269) 341-9919
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010192
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201010192
STATE LICENSE
MI
Enumeration date
10/22/2018
Last updated
10/09/2020
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