Healthcare Provider Details

I. General information

NPI: 1922469386
Provider Name (Legal Business Name): KAYLA CAREY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2016
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1105
TABERNASH CO
80478-0206
US

IV. Provider business mailing address

PO BOX 1105
TABERNASH CO
80478-0206
US

V. Phone/Fax

Practice location:
  • Phone: 404-547-5306
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0005460
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: