Provider Demographics
NPI:1164898920
Name:BARRETT, KAYLA WHITING (DPT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:WHITING
Last Name:BARRETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:MARGARET
Other - Last Name:WHITING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4 RICHMOND SQ STE 200
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5117
Mailing Address - Country:US
Mailing Address - Phone:401-433-4172
Mailing Address - Fax:401-433-0612
Practice Address - Street 1:1235 WAMPANOAG TRL STE 5
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-1231
Practice Address - Country:US
Practice Address - Phone:401-433-4049
Practice Address - Fax:401-270-0118
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist