Provider Demographics
NPI:1629517628
Name:PREECE, KAYLEE M (MSOTR/L)
Entity Type:Individual
Prefix:MISS
First Name:KAYLEE
Middle Name:M
Last Name:PREECE
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:M
Other - Last Name:FAULKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTR/L
Mailing Address - Street 1:10 GEORGE ST
Mailing Address - Street 2:#310
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-2241
Mailing Address - Country:US
Mailing Address - Phone:978-452-1776
Mailing Address - Fax:
Practice Address - Street 1:386 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5885
Practice Address - Country:US
Practice Address - Phone:978-965-5089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA478643225XN1300X, 225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics