Provider Demographics
NPI:1659048684
Name:GUTCHESS, KARLEY NICHOLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KARLEY
Middle Name:NICHOLE
Last Name:GUTCHESS
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 1:7623 HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-9408
Mailing Address - Country:US
Mailing Address - Phone:315-744-3149
Mailing Address - Fax:
Practice Address - Street 1:5460 MELTZER CT
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-9430
Practice Address - Country:US
Practice Address - Phone:315-699-1619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist