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General NPI Number Information
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NPI Number | 1215326277
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Entity Type | Individual
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Provider Name | KAYLA INGERSON OT
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Gender | Female
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 4122 TERRY DR
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City | CHESAPEAKE
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State | VA
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Zip | 23321-4597
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Country | US
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Telephone | 757-638-7951
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Fax |
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Provider Business Mailing Address
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Address Line | 11193 PARK PL
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City | SMITHFIELD
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State | VA
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Zip | 23430-5735
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Country | US
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Telephone | 207-299-4199
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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 | 004288
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119006640
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License Number State | VA
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