Provider Demographics
NPI:1528332350
Name:KUZNESKI, RENA M (OT)
Entity type:Individual
Prefix:
First Name:RENA
Middle Name:M
Last Name:KUZNESKI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-1815
Mailing Address - Country:US
Mailing Address - Phone:724-471-2029
Mailing Address - Fax:
Practice Address - Street 1:1800 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:DAVIDSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15928-9231
Practice Address - Country:US
Practice Address - Phone:814-288-2318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008411225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist