Provider Demographics
NPI:1891865424
Name:KIDANE, DANUSIA (OTR)
Entity type:Individual
Prefix:MS
First Name:DANUSIA
Middle Name:
Last Name:KIDANE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:DANUSIA
Other - Middle Name:
Other - Last Name:BOROWSKA- MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:19 WILOWA LN
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1454
Mailing Address - Country:US
Mailing Address - Phone:505-690-0662
Mailing Address - Fax:
Practice Address - Street 1:826 CAMINO DEL MONTE REY
Practice Address - Street 2:SUITE A2
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3977
Practice Address - Country:US
Practice Address - Phone:505-954-9940
Practice Address - Fax:505-954-9946
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1562225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist