Healthcare Provider Details

I. General information

NPI: 1538923933
Provider Name (Legal Business Name): KAYLA JAYNE STEVENS MS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 ELLA P BURR ST
LINCOLN ME
04457-1721
US

IV. Provider business mailing address

PO BOX 611
HOWLAND ME
04448-0611
US

V. Phone/Fax

Practice location:
  • Phone: 207-794-3014
  • Fax:
Mailing address:
  • Phone: 207-267-0037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT4544
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT4544
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: