Healthcare Provider Details

I. General information

NPI: 1710594239
Provider Name (Legal Business Name): KAYLA REBECCA MEHAFFY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA REBECCA SMITH

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 TURNPIKE DR UNIT 100
WESTMINSTER CO
80031-7042
US

IV. Provider business mailing address

8501 TURNPIKE DR UNIT 100
WESTMINSTER CO
80031-7042
US

V. Phone/Fax

Practice location:
  • Phone: 303-430-2490
  • Fax:
Mailing address:
  • Phone: 612-940-9480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2020007319
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0007323
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: