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General NPI Number Information
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NPI Number | 1255048906
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Entity Type | Individual
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Provider Name | KAITLYN PAIGE O'KELLY OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/02/2022
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 2850 W HORIZON RIDGE PKWY STE 320
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City | HENDERSON
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State | NV
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Zip | 89052-4395
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Country | US
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Telephone | 702-564-4116
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Fax |
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Provider Business Mailing Address
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Address Line | 8138 VISION ST
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City | LAS VEGAS
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State | NV
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Zip | 89123-0211
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Country | US
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Telephone | 918-269-1324
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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 | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 3108
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License Number State | NV
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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 | 3108
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License Number State | NV
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