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NPI Code Detail

MEDICARE: KAILEY ELIZABETH LANGE OTD, OTR/L

MEDICARE: KAILEY ELIZABETH LANGE 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 TherapistOT012068OH

General Provider Information

NPI Number : 1245046911
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAILEY ELIZABETH LANGE OTD, OTR/L
Provider Business Mailing Address
First Line : 7650 RED FOX TRL
Second Line :
City : HUDSON
State : OH
Zip : 44236-1926
Country : US
Telephone Number : 216-407-4958
Fax Number :
Provider Business Practice Location Address
First Line : 261 RICHMOND RD
Second Line :
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-4422
Country : US
Telephone Number : 440-565-0008
Fax Number : 440-565-0011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2024
Last Update Date : 12/09/2024

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Directions to “ KAILEY ELIZABETH LANGE OTD, OTR/L” Practice Location

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