Provider Demographics
NPI:1437706496
Name:KING, KAYLA ANN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:ANN
Last Name:KING
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 1:17387 GREENSPIRE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-9563
Mailing Address - Country:US
Mailing Address - Phone:616-334-4707
Mailing Address - Fax:
Practice Address - Street 1:17387 GREENSPIRE DR
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-9563
Practice Address - Country:US
Practice Address - Phone:616-334-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist