Provider Demographics
NPI:1689851008
Name:MALERBA, KIRSTEN HAWKINS (PT, DPT, PCS)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:HAWKINS
Last Name:MALERBA
Suffix:
Gender:F
Credentials:PT, DPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 NELSON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2300
Mailing Address - Country:US
Mailing Address - Phone:404-488-4750
Mailing Address - Fax:
Practice Address - Street 1:330 NELSON FERRY RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2300
Practice Address - Country:US
Practice Address - Phone:404-488-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0071642251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics