Provider Demographics
NPI:1821602335
Name:KLINE, GABRIELLA CAITRIN (OTR)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:CAITRIN
Last Name:KLINE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 N 56TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-1607
Mailing Address - Country:US
Mailing Address - Phone:414-732-1360
Mailing Address - Fax:
Practice Address - Street 1:HARBORCHASE OF SHOREWOOD
Practice Address - Street 2:1111 E CAPITOL DRIVE
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211
Practice Address - Country:US
Practice Address - Phone:414-455-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI671926225X00000X
WI6719-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist