Provider Demographics
NPI:1730850892
Name:HOUTZ, KATELYN (OTD)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:HOUTZ
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 MORTISE LOOP
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-5700
Mailing Address - Country:US
Mailing Address - Phone:775-397-5126
Mailing Address - Fax:
Practice Address - Street 1:1039 MORTISE LOOP
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-5700
Practice Address - Country:US
Practice Address - Phone:775-397-5126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOTP-OT-LIC-8564225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist