Provider Demographics
NPI:1821779307
Name:MCCROREY, KAILEY (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAILEY
Middle Name:
Last Name:MCCROREY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KAILEY
Other - Middle Name:
Other - Last Name:MCCROREY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5 COVENANT CT
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-9241
Mailing Address - Country:US
Mailing Address - Phone:215-622-1107
Mailing Address - Fax:
Practice Address - Street 1:607 NORTH AVE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1322
Practice Address - Country:US
Practice Address - Phone:781-245-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14966225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist