Provider Demographics
NPI:1477096691
Name:MULES, KAITLIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:MULES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5444 QUENTIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2817
Mailing Address - Country:US
Mailing Address - Phone:410-259-5934
Mailing Address - Fax:
Practice Address - Street 1:5444 QUENTIN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2817
Practice Address - Country:US
Practice Address - Phone:410-259-5934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-19
Last Update Date:2016-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC012683225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics