Provider Demographics
NPI:1780880682
Name:SIKORSKI, KRISTINE (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:
Last Name:SIKORSKI
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6899 S 300 E
Mailing Address - Street 2:
Mailing Address - City:MARKLEVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46056-9749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2020 MERIDIAN ST STE 170
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-4343
Practice Address - Country:US
Practice Address - Phone:765-646-8663
Practice Address - Fax:765-683-3239
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000883A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200620160Medicaid