Provider Demographics
NPI:1205383379
Name:KORTYKA, DONNA (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:KORTYKA
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 NORTH HIGH STREET
Mailing Address - Street 2:OHIO STATE SCHOOL FOR THE BLIND
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214
Mailing Address - Country:US
Mailing Address - Phone:614-752-1359
Mailing Address - Fax:
Practice Address - Street 1:5220 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1240
Practice Address - Country:US
Practice Address - Phone:614-752-1359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000917225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist