Provider Demographics
NPI:1063084291
Name:DINABOURGSKI, KATHRINE (OTR/L)
Entity type:Individual
Prefix:
First Name:KATHRINE
Middle Name:
Last Name:DINABOURGSKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 FIRST EDITION DR APT 812
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-0887
Mailing Address - Country:US
Mailing Address - Phone:305-215-8450
Mailing Address - Fax:
Practice Address - Street 1:101 E MARKET ST STE 3B
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-3981
Practice Address - Country:US
Practice Address - Phone:919-912-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14161225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14161OtherNORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY