Provider Demographics
NPI:1295984045
Name:KOWALSKI, KATHERINE (OT)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 WATER ST
Mailing Address - Street 2:SUITE C 104
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4060
Mailing Address - Country:US
Mailing Address - Phone:508-746-4434
Mailing Address - Fax:508-746-4432
Practice Address - Street 1:225 WATER ST
Practice Address - Street 2:SUITE C 104
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4060
Practice Address - Country:US
Practice Address - Phone:508-746-4434
Practice Address - Fax:508-746-4432
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4341225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAOT0036OtherBLUE CROSS BLUE SHIELD
MAY69221Medicare PIN