Provider Demographics
NPI:1215534169
Name:ALLEN, KAYLEIGH (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BERRYVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22611-1066
Mailing Address - Country:US
Mailing Address - Phone:703-554-2162
Mailing Address - Fax:
Practice Address - Street 1:17810 MEETING HOUSE RD STE 100
Practice Address - Street 2:
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1039
Practice Address - Country:US
Practice Address - Phone:703-554-2162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty