Provider Demographics
NPI:1417251604
Name:HARNISH, KATHRYN ANGELA (RPT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ANGELA
Last Name:HARNISH
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 ALGIN DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-3011
Mailing Address - Country:US
Mailing Address - Phone:203-577-2027
Mailing Address - Fax:
Practice Address - Street 1:778 MIDDLEBURY RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2401
Practice Address - Country:US
Practice Address - Phone:203-758-2471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-02
Last Update Date:2011-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist