Provider Demographics
NPI:1336533884
Name:URBANOVSKY, KATLYN (OTR)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:URBANOVSKY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MEDICAL DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3102
Mailing Address - Country:US
Mailing Address - Phone:361-578-2257
Mailing Address - Fax:361-578-2260
Practice Address - Street 1:117 MEDICAL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3102
Practice Address - Country:US
Practice Address - Phone:361-578-2257
Practice Address - Fax:361-578-2260
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116741225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist