Provider Demographics
NPI:1760244008
Name:QUINN, KAYLEE ROSE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:ROSE
Last Name:QUINN
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 1:124 SUGAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-4044
Mailing Address - Country:US
Mailing Address - Phone:203-843-8451
Mailing Address - Fax:
Practice Address - Street 1:469 W MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3400
Practice Address - Country:US
Practice Address - Phone:679-020-3828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6286225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist