Provider Demographics
NPI:1972395747
Name:HARPER, KATLYN NICOLE (OTR/L)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:NICOLE
Last Name:HARPER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-3403
Mailing Address - Country:US
Mailing Address - Phone:856-328-4107
Mailing Address - Fax:
Practice Address - Street 1:151 E MINNEHAHA AVE
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3424
Practice Address - Country:US
Practice Address - Phone:352-394-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10430225X00000X
FLOT26170225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist