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General NPI Number Information
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NPI Number | 1093085136
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Entity Type | Individual
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Provider Name | KAYLA DAVIS OTR
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Gender | Female
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 3177 MERIDIAN PARKE DR
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City | GREENWOOD
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State | IN
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Zip | 46142-9629
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Country | US
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Telephone | 317-794-5334
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Fax |
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Provider Business Mailing Address
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Address Line | 915 MOONLIGHT CT
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City | MOORESVILLE
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State | IN
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Zip | 46158-7510
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Country | US
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Telephone | 812-686-9299
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31005155A
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License Number State | IN
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