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General NPI Number Information
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NPI Number | 1740654383
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Entity Type | Individual
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Provider Name | KAYLA GROSS
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Gender | Female
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 5750 DTC PARKWAY SUITE 170
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-5483
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Country | US
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Telephone | 303-504-9945
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Fax |
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Provider Business Mailing Address
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Address Line | 2015 N ST
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City | GERING
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State | NE
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Zip | 69341-2634
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Country | US
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Telephone | 307-575-2071
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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 | 2695
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License Number State | NE
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