Provider Demographics
NPI:1861674541
Name:JAIN, KAVITA KUMARI (OTR)
Entity Type:Individual
Prefix:MS
First Name:KAVITA
Middle Name:KUMARI
Last Name:JAIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 1/2 S SPRING ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2427
Mailing Address - Country:US
Mailing Address - Phone:603-224-3421
Mailing Address - Fax:
Practice Address - Street 1:198 PEARL ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-4357
Practice Address - Country:US
Practice Address - Phone:603-669-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1695225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist