Provider Demographics
NPI:1639943293
Name:MORGAN, KAYLA MICHELLE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MICHELLE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26071 ROUTE A
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAY
Mailing Address - State:MO
Mailing Address - Zip Code:65258-2018
Mailing Address - Country:US
Mailing Address - Phone:660-346-1999
Mailing Address - Fax:
Practice Address - Street 1:1010 US HIGHWAY 24 AND 36 E
Practice Address - Street 2:
Practice Address - City:MONROE CITY
Practice Address - State:MO
Practice Address - Zip Code:63456-1116
Practice Address - Country:US
Practice Address - Phone:660-346-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013002541224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant