Provider Demographics
NPI:1053602144
Name:PITOU, KATHERINE ANN (OTR)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:PITOU
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ANN
Other - Last Name:KLUG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:965 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4057
Mailing Address - Country:US
Mailing Address - Phone:614-784-0400
Mailing Address - Fax:614-784-0401
Practice Address - Street 1:965 HIGH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4057
Practice Address - Country:US
Practice Address - Phone:614-784-0400
Practice Address - Fax:614-784-0401
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT004392225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111390OtherTX LICENSE
OHOT004392OtherOH LICENSE