Provider Demographics
NPI:1538700125
Name:MONHOLLAND, KAYLA MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:MONHOLLAND
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:MARIE
Other - Last Name:REININGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2244 E SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-1443
Mailing Address - Country:US
Mailing Address - Phone:918-684-9999
Mailing Address - Fax:
Practice Address - Street 1:2244 E SHAWNEE RD
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-1443
Practice Address - Country:US
Practice Address - Phone:918-684-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2144225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2144OtherLICENSE