Provider Demographics
NPI:1538682166
Name:KOHANSKI, KENDRA-LYNN ELIZABETH (DPT, PT)
Entity Type:Individual
Prefix:MS
First Name:KENDRA-LYNN
Middle Name:ELIZABETH
Last Name:KOHANSKI
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:MS
Other - First Name:KENDRA
Other - Middle Name:
Other - Last Name:KOHANSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:214 CONSTITUTION CT APT 104
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-7803
Mailing Address - Country:US
Mailing Address - Phone:401-316-5252
Mailing Address - Fax:
Practice Address - Street 1:1525 SMITH ST STE 5
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02911-2959
Practice Address - Country:US
Practice Address - Phone:401-353-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist