Healthcare Provider Details

I. General information

NPI: 1447347380
Provider Name (Legal Business Name): DANIELLE KAGAN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 RIVERSIDE AVE
WESTPORT CT
06880-4825
US

IV. Provider business mailing address

18444 N 25TH AVE STE 310
PHOENIX AZ
85023-1266
US

V. Phone/Fax

Practice location:
  • Phone: 203-845-2200
  • Fax:
Mailing address:
  • Phone: 623-241-8682
  • Fax: 480-499-8459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number005540
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number48.005540
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0077551
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: