Individual
KATHRYN LYNN MALICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5219 88TH AVE, KENOSHA, WI 53144-7468
(262) 653-0850
(262) 653-0853
Mailing address
1114 RIVERVIEW CT, GRAFTON, WI 53024-1609
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5122-26
WI
Other
Enumeration date
01/17/2012
Last updated
01/17/2012
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