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Individual

KATHERINE MICHELLE GAZELKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1085 MEDICAL CENTER DR, SAN BERNARDINO, CA 92411-2023
(909) 877-6333
Mailing address
30041 TESSIER APT 292, LAGUNA NIGUEL, CA 92677-8912
(218) 255-2725

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
105507
MN
225X00000X
Occupational Therapist
Primary
21973
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346750866
MN
Enumeration date
10/10/2017
Last updated
02/12/2021
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