Provider Demographics
NPI:1114207933
Name:HEJNA, KATHRYN ROSE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ROSE
Last Name:HEJNA
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 1:2210 WHITING DR
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-6900
Mailing Address - Country:US
Mailing Address - Phone:605-665-0708
Mailing Address - Fax:
Practice Address - Street 1:1212 W 8TH ST
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-3307
Practice Address - Country:US
Practice Address - Phone:605-665-0778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1161225X00000X
SD0632225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist