Provider Demographics
NPI:1649482076
Name:KLOWSKY, DEBRA B (OT)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:B
Last Name:KLOWSKY
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 1:6504 THOMAS PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-8159
Mailing Address - Country:US
Mailing Address - Phone:815-871-4015
Mailing Address - Fax:815-637-4374
Practice Address - Street 1:6504 THOMAS PKWY
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-8159
Practice Address - Country:US
Practice Address - Phone:815-871-4015
Practice Address - Fax:815-637-4374
Is Sole Proprietor?:No
Enumeration Date:2007-05-06
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-003449225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics