Provider Demographics
NPI:1225349723
Name:KWIECINSKA, KATHERINE MAGDALENA (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:KATHERINE
Middle Name:MAGDALENA
Last Name:KWIECINSKA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3257 MCDOWELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MISSISSAUGA
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L5M6S1
Mailing Address - Country:CA
Mailing Address - Phone:559-901-7190
Mailing Address - Fax:
Practice Address - Street 1:72201 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4001
Practice Address - Country:US
Practice Address - Phone:760-340-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0T10546225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist