MEDICARE: KAYLEIGH R LITTLE-PARKS OTR/L

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	225X00000X	Occupational Therapist	14926	MA

General Provider Information

NPI Number	:	1598239600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEIGH R LITTLE-PARKS OTR/L

Provider Business Mailing Address
First Line	:	47 TARAMAC RD
Second Line	:
City	:	CENTERVILLE
State	:	MA
Zip	:	02632-2721
Country	:	US
Telephone Number	:	774-487-5074
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 CORDAGE PARK CIR
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-7318
Country	:	US
Telephone Number	:	508-830-2182
Fax Number	:

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

Provider Enumeration Date	:	01/11/2019
Last Update Date	:	03/12/2026

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