Provider Demographics
NPI:1619473865
Name:HARTT, KAYLA M (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:M
Last Name:HARTT
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 1:20 BIRCHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-5124
Mailing Address - Country:US
Mailing Address - Phone:207-554-0127
Mailing Address - Fax:
Practice Address - Street 1:20 BIRCHWOOD AVE
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-5124
Practice Address - Country:US
Practice Address - Phone:207-554-0127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME3434225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics