Basic Information
Provider Information
NPI: 1306282678
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KILLINGER
FirstName: CATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7507 E WINDSOR AVE
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852571525
CountryCode: US
TelephoneNumber: 3528744633
FaxNumber:  
Practice Location
Address1: 521 NE 25TH AVE
Address2:  
City: OCALA
State: FL
PostalCode: 344707034
CountryCode: US
TelephoneNumber: 3524017916
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/14/2013
LastUpdateDate: 04/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X12870FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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