Provider Demographics
NPI:1649410242
Name:O'REILLY, KYNDRA R (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KYNDRA
Middle Name:R
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W HUFFAKER LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2345
Mailing Address - Country:US
Mailing Address - Phone:775-852-4342
Mailing Address - Fax:775-852-9136
Practice Address - Street 1:150 W HUFFAKER LN
Practice Address - Street 2:SUITE 105
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2345
Practice Address - Country:US
Practice Address - Phone:775-852-4342
Practice Address - Fax:775-852-9136
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV09-0102225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV09-0102OtherNEVADA OCCUPATIONAL THERAPY LICENSE