Provider Demographics
NPI:1790330348
Name:SCHLEDORN, KATHRYN MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:SCHLEDORN
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 1:9264 WOODSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-9148
Mailing Address - Country:US
Mailing Address - Phone:585-245-4206
Mailing Address - Fax:
Practice Address - Street 1:104 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:NY
Practice Address - Zip Code:14735-8651
Practice Address - Country:US
Practice Address - Phone:585-567-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023823225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist