Provider Demographics
NPI:1457087017
Name:KIENAN, KALINA MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KALINA
Middle Name:MARIE
Last Name:KIENAN
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 1:115 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:14425-7065
Mailing Address - Country:US
Mailing Address - Phone:585-489-9911
Mailing Address - Fax:
Practice Address - Street 1:115 SUNSET DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NY
Practice Address - Zip Code:14425-7065
Practice Address - Country:US
Practice Address - Phone:585-489-9911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020131225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist