Provider Demographics
NPI:1437727526
Name:O'BRIEN, KYLE H (PHD DHSC LCSW OTR/L)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:H
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:PHD DHSC LCSW OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SILVER BROOK LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2570
Mailing Address - Country:US
Mailing Address - Phone:203-526-1607
Mailing Address - Fax:
Practice Address - Street 1:4 SILVER BROOK LN
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-2570
Practice Address - Country:US
Practice Address - Phone:203-526-1607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3833225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist