Provider Demographics
NPI:1265550495
Name:HORWITZ, KATHLEEN MCHENRY (MS, MPT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MCHENRY
Last Name:HORWITZ
Suffix:
Gender:F
Credentials:MS, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18306 CRANBERRY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-4807
Mailing Address - Country:US
Mailing Address - Phone:440-708-1293
Mailing Address - Fax:866-267-0406
Practice Address - Street 1:18306 CRANBERRY RIDGE LN
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4807
Practice Address - Country:US
Practice Address - Phone:440-463-8165
Practice Address - Fax:866-267-0406
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-076052251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000370512OtherANTHEM BLUE CROSS BLUE SH
OH2520712Medicaid
OH000000370512OtherANTHEM BLUE CROSS BLUE SH