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NPI Code Detail

MEDICARE: KAYLA BOLAND

MEDICARE:   KAYLA  BOLAND
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
1224Z00000XOccupational Therapy Assistant201795MN

General Provider Information

NPI Number : 1205219177
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA BOLAND
Provider Business Mailing Address
First Line : 1740 BLUEWATER LN
Second Line :
City : WOODBURY
State : MN
Zip : 55129-6236
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7012 LAKE RD
Second Line :
City : WOODBURY
State : MN
Zip : 55125-2433
Country : US
Telephone Number : 651-287-9529
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2015
Last Update Date : 07/09/2015

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Directions to “ KAYLA BOLAND ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.