Provider Demographics
NPI:1780788208
Name:STELIK, KATHY F (OTRL)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:F
Last Name:STELIK
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:88 NORWICH NEW LONDON TPKE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:UNCASVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06382-2518
Mailing Address - Country:US
Mailing Address - Phone:860-848-9157
Mailing Address - Fax:860-848-3471
Practice Address - Street 1:88 NORWICH NEW LONDON TPKE
Practice Address - Street 2:SUITE 1
Practice Address - City:UNCASVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382-2518
Practice Address - Country:US
Practice Address - Phone:860-848-9157
Practice Address - Fax:860-848-3471
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000079225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT130000079CT03OtherBCBS ID NUMBER
RI29195-6OtherBCBS RI NUMBER
CT2V7212OtherHEALTHNET ID NUMBER