Provider Demographics
NPI:1437887957
Name:DELACRUZ, KAYLI L (OTR)
Entity Type:Individual
Prefix:
First Name:KAYLI
Middle Name:L
Last Name:DELACRUZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ELLIOTT ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-1607
Mailing Address - Country:US
Mailing Address - Phone:732-589-1830
Mailing Address - Fax:
Practice Address - Street 1:106 ELLIOTT ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1607
Practice Address - Country:US
Practice Address - Phone:732-589-1830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0012409225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist