Provider Demographics
NPI:1477722148
Name:HOLDREN, KRISTEN CATHERINE (OTR)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:CATHERINE
Last Name:HOLDREN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:CATHERINE
Other - Last Name:GORCZYCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 NW KENDALL AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66618-1436
Mailing Address - Country:US
Mailing Address - Phone:214-316-7330
Mailing Address - Fax:
Practice Address - Street 1:7819 CONSER PL
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-2820
Practice Address - Country:US
Practice Address - Phone:913-789-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-03900225X00000X
WATL10000824225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist