Provider Demographics
NPI:1164720405
Name:STEARNS, KAYLIE ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAYLIE
Middle Name:ANN
Last Name:STEARNS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2139
Mailing Address - Country:US
Mailing Address - Phone:616-402-6997
Mailing Address - Fax:
Practice Address - Street 1:533 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2139
Practice Address - Country:US
Practice Address - Phone:616-402-6997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008825225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics