Provider Demographics
NPI:1043653272
Name:ROE, KATELYN M (MS, OTR/L, HPCS)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:M
Last Name:ROE
Suffix:
Gender:F
Credentials:MS, OTR/L, HPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 MARRIOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MARRIOTTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21104-1331
Mailing Address - Country:US
Mailing Address - Phone:443-866-3805
Mailing Address - Fax:
Practice Address - Street 1:1 OLYMPIC PLACE ROOM 200
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21252-6283
Practice Address - Country:US
Practice Address - Phone:410-704-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07466225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist