Healthcare Provider Details

I. General information

NPI: 1437400306
Provider Name (Legal Business Name): KAYLA MARIE BROWN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 10/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 BETHEL RD
COLUMBUS OH
43220-2262
US

IV. Provider business mailing address

3000 BETHEL RD
COLUMBUS OH
43220-2262
US

V. Phone/Fax

Practice location:
  • Phone: 614-889-6320
  • Fax:
Mailing address:
  • Phone: 614-889-6320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number007953
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: