Provider Demographics
NPI:1538657820
Name:PATTERSON, KYLENE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KYLENE
Middle Name:
Last Name:PATTERSON
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 1:119 REDEMPTION ROCK TRL
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MA
Mailing Address - Zip Code:01564-2446
Mailing Address - Country:US
Mailing Address - Phone:774-345-0827
Mailing Address - Fax:
Practice Address - Street 1:3 VISION DR
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-2059
Practice Address - Country:US
Practice Address - Phone:508-655-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8502225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist