Healthcare Provider Details

I. General information

NPI: 1306756523
Provider Name (Legal Business Name): KAITLYNN STANTON OTD, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 GREENWAY DR STE 500
IRVING TX
75038-2444
US

IV. Provider business mailing address

1431 GREENWAY DR STE 500
IRVING TX
75038-2444
US

V. Phone/Fax

Practice location:
  • Phone: 241-281-8365
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number126833
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: