Healthcare Provider Details

I. General information

NPI: 1942242466
Provider Name (Legal Business Name): KRISTEN LOOSE DPT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 OLD LANDING RD STE 102
MILLSBORO DE
19966-1249
US

IV. Provider business mailing address

395 OLD LANDING RD STE 102
MILLSBORO DE
19966-1249
US

V. Phone/Fax

Practice location:
  • Phone: 302-934-3922
  • Fax: 302-894-1601
Mailing address:
  • Phone: 302-934-3922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberU1-0000475
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0001953
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: