Healthcare Provider Details

I. General information

NPI: 1679021760
Provider Name (Legal Business Name): KAYLA NICOLE PERKINSON OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5314 W FRIENDLY AVE STE E
GREENSBORO NC
27410-4351
US

IV. Provider business mailing address

5314 W FRIENDLY AVE STE E
GREENSBORO NC
27410-4351
US

V. Phone/Fax

Practice location:
  • Phone: 336-285-7324
  • Fax: 336-579-0693
Mailing address:
  • Phone: 336-285-7324
  • Fax: 336-579-0693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9121
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number9121
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number9121
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: