Provider Demographics
NPI:1609573989
Name:O'HARA, KAITLYN ELIZABETH (CPC-I)
Entity Type:Individual
Prefix:MISS
First Name:KAITLYN
Middle Name:ELIZABETH
Last Name:O'HARA
Suffix:
Gender:F
Credentials:CPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5011 MEADOWOOD MALL CIR STE 301
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6576
Mailing Address - Country:US
Mailing Address - Phone:775-234-8551
Mailing Address - Fax:
Practice Address - Street 1:5011 MEADOWOOD MALL CIR STE 301
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6576
Practice Address - Country:US
Practice Address - Phone:775-234-8551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI5239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health