Healthcare Provider Details

I. General information

NPI: 1922471838
Provider Name (Legal Business Name): KAYLA GASKIN MS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 7TH AVE
HUNTINGTON WV
25701-2117
US

IV. Provider business mailing address

3007 FAIRWAY DR
FLOYDS KNOBS IN
47119-9617
US

V. Phone/Fax

Practice location:
  • Phone: 304-523-1164
  • Fax: 304-522-2474
Mailing address:
  • Phone: 502-295-3746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31005977A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberBOTOCT00222569
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: