Healthcare Provider Details

I. General information

NPI: 1174246797
Provider Name (Legal Business Name): KATE-LYNN GAYLORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 TURNER RD
MORETOWN VT
05660-9775
US

IV. Provider business mailing address

PO BOX 647
MONTPELIER VT
05601-0647
US

V. Phone/Fax

Practice location:
  • Phone: 802-279-9878
  • Fax:
Mailing address:
  • Phone: 802-229-1399
  • Fax: 802-223-8623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number072.0122946
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number072.0122946
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: