Provider Demographics
NPI:1265757603
Name:KADLECIK, JANET (OTR)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:KADLECIK
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 1:2275 NE DOCTORS DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6324
Mailing Address - Country:US
Mailing Address - Phone:541-306-6175
Mailing Address - Fax:541-306-6244
Practice Address - Street 1:2275 NE DOCTORS DR
Practice Address - Street 2:SUITE 4
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6324
Practice Address - Country:US
Practice Address - Phone:541-306-6175
Practice Address - Fax:541-306-6244
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR419788225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist