Provider Demographics
NPI:1861649394
Name:KINES, KATARZYNA (CNS, LDN, MS)
Entity Type:Individual
Prefix:MRS
First Name:KATARZYNA
Middle Name:
Last Name:KINES
Suffix:
Gender:F
Credentials:CNS, LDN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5607 MATTFELDT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3712
Mailing Address - Country:US
Mailing Address - Phone:443-926-6841
Mailing Address - Fax:410-321-1084
Practice Address - Street 1:2360 W JOPPA RD
Practice Address - Street 2:SUITE # 200
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4624
Practice Address - Country:US
Practice Address - Phone:443-926-6841
Practice Address - Fax:410-321-1084
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX2610133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist