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NPI Code Detail

MEDICARE: KAILA AURELIA OTR/L

MEDICARE: KAILA AURELIA 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 Therapist004552CT

General Provider Information

NPI Number : 1164881421
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAILA AURELIA OTR/L
Provider Business Mailing Address
First Line : 21 TURTLEBROOK TRL
Second Line :
City : MONROE
State : CT
Zip : 06468-2625
Country : US
Telephone Number : 203-788-7751
Fax Number :
Provider Business Practice Location Address
First Line : 100 REDDING RD
Second Line :
City : REDDING
State : CT
Zip : 06896-3236
Country : US
Telephone Number : 203-450-7846
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2016
Last Update Date : 01/13/2018

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Directions to “ KAILA AURELIA OTR/L” Practice Location

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