Provider Demographics
NPI:1265213177
Name:LAUX, KATHERINE (LCAT-LP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:LAUX
Suffix:
Gender:F
Credentials:LCAT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 STONE QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5306
Mailing Address - Country:US
Mailing Address - Phone:607-227-0411
Mailing Address - Fax:
Practice Address - Street 1:537 GLENMARY DR
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-2009
Practice Address - Country:US
Practice Address - Phone:607-298-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP124421221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist