Provider Demographics
NPI:1629785043
Name:DEHNE, KYLIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:DEHNE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:
Other - Last Name:CAISLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:944 MACY LN
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:AR
Mailing Address - Zip Code:72727-5003
Mailing Address - Country:US
Mailing Address - Phone:480-529-0703
Mailing Address - Fax:
Practice Address - Street 1:1100 DIVISION ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE GROVE
Practice Address - State:AR
Practice Address - Zip Code:72753-5501
Practice Address - Country:US
Practice Address - Phone:479-334-0014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3634225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist