Provider Demographics
NPI:1508095779
Name:HORKY, KRISTIN M (OT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:HORKY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 HIGHWAY 96 W
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-1960
Mailing Address - Country:US
Mailing Address - Phone:651-451-3016
Mailing Address - Fax:651-481-7040
Practice Address - Street 1:490 HIGHWAY 96 W
Practice Address - Street 2:SUITE 300
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-1960
Practice Address - Country:US
Practice Address - Phone:651-451-3016
Practice Address - Fax:651-481-7040
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103731225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist