Provider Demographics
NPI:1013149715
Name:APOLLO, KRYSTYNA ANDREA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTYNA
Middle Name:ANDREA
Last Name:APOLLO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KRYSTYNA
Other - Middle Name:ANDREA
Other - Last Name:ZUKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8621 W BELOIT RD
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-3771
Mailing Address - Country:US
Mailing Address - Phone:414-607-4191
Mailing Address - Fax:
Practice Address - Street 1:8621 W BELOIT RD
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-3771
Practice Address - Country:US
Practice Address - Phone:414-607-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4429-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist