Healthcare Provider Details

I. General information

NPI: 1780162214
Provider Name (Legal Business Name): KAITLYN ELIZABETH BROWN MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 08/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7560 FOREST RD
CINCINNATI OH
45255-4307
US

IV. Provider business mailing address

11083 HAMILTON AVE
CINCINNATI OH
45231-1409
US

V. Phone/Fax

Practice location:
  • Phone: 513-232-2772
  • Fax:
Mailing address:
  • Phone: 513-674-4200
  • Fax: 513-742-8339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT008523
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: