Provider Demographics
NPI:1518748359
Name:WILL, KRISTIN KENDRICK (OTD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:KENDRICK
Last Name:WILL
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6758 E FREMONT PL
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1572
Mailing Address - Country:US
Mailing Address - Phone:720-629-6980
Mailing Address - Fax:
Practice Address - Street 1:6758 E FREMONT PL
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1572
Practice Address - Country:US
Practice Address - Phone:720-629-6980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005036225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist