Healthcare Provider Details

I. General information

NPI: 1609270081
Provider Name (Legal Business Name): KAITLYN TRAYNOR M.S., OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 BUTLER STREET
SALEM NH
03079
US

IV. Provider business mailing address

70 BUTLER STREET
SALEM NH
03079
US

V. Phone/Fax

Practice location:
  • Phone: 603-893-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number2416
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: