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NPI Code Detail

MEDICARE: DR. KAILA AMRI MANGRUM OTD, OTR/L

MEDICARE:  DR. KAILA AMRI MANGRUM  OTD, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOT-3769NV

General Provider Information

NPI Number : 1033082508
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAILA AMRI MANGRUM OTD, OTR/L
Provider Business Mailing Address
First Line : 1225 TRIUMPH CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-7122
Country : US
Telephone Number : 702-350-2652
Fax Number : 775-571-8976
Provider Business Practice Location Address
First Line : 1225 TRIUMPH CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-7122
Country : US
Telephone Number : 702-350-2652
Fax Number : 775-571-8976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2025
Last Update Date : 09/29/2025

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Directions to “ DR. KAILA AMRI MANGRUM OTD, OTR/L” Practice Location

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