Provider Demographics
NPI:1659073146
Name:KAUFMAN, KRISTA L (OT/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:L
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6002 SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-2861
Mailing Address - Country:US
Mailing Address - Phone:317-525-8386
Mailing Address - Fax:844-556-4672
Practice Address - Street 1:6002 SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-2861
Practice Address - Country:US
Practice Address - Phone:317-525-8386
Practice Address - Fax:844-556-4672
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist