MEDICARE: CAITLYN REANN COTTRELL OTD, OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	124729	TX

General Provider Information

NPI Number	:	1407707979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLYN REANN COTTRELL OTD, OTR

Provider Business Mailing Address
First Line	:	1502 BLUE RIDGE DR STE 200
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-1002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 BLUE RIDGE DR STE 200
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-1002
Country	:	US
Telephone Number	:	737-738-7768
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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