Provider Demographics
NPI:1760164420
Name:MOGELESKY, CAITLIN GRIMES
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:GRIMES
Last Name:MOGELESKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 CRYSTAL CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-2225
Mailing Address - Country:US
Mailing Address - Phone:302-354-6908
Mailing Address - Fax:
Practice Address - Street 1:3103 CRYSTAL CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-2225
Practice Address - Country:US
Practice Address - Phone:302-354-6908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist