Basic Information
| Provider Information | |||||||||
| NPI: | 1235632902 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GORKOWSKI | ||||||||
| FirstName: | KATHERINE | ||||||||
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| Credential: | MOT, OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6561 WINANS LAKE RD | ||||||||
| Address2: | |||||||||
| City: | BRIGHTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481165124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9062363934 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12319 HIGHLAND RD STE 501 | ||||||||
| Address2: | |||||||||
| City: | HARTLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483532946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8109911211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2018 | ||||||||
| LastUpdateDate: | 03/08/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 5201009975 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.