Provider Demographics
NPI:1225322621
Name:KAIN, KELLY S (OTR/L)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:S
Last Name:KAIN
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 1:1282 PENNSBURY BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-1639
Mailing Address - Country:US
Mailing Address - Phone:412-279-3310
Mailing Address - Fax:
Practice Address - Street 1:1282 PENNSBURY BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-1639
Practice Address - Country:US
Practice Address - Phone:412-279-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005320L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist