Healthcare Provider Details

I. General information

NPI: 1902328636
Provider Name (Legal Business Name): KAYLIE MARIE JONES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 HARRISON ST
SYRACUSE NY
13210-2395
US

IV. Provider business mailing address

12 KNIGHTS CIR
BALDWINSVILLE NY
13027-8256
US

V. Phone/Fax

Practice location:
  • Phone: 315-435-4244
  • Fax:
Mailing address:
  • Phone: 518-955-8765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number021648
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: