Provider Demographics
NPI:1881003127
Name:PFEIFER, KAITLIN (COTA/L)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:PFEIFER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 CARPENTERTOWN MINE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-2912
Mailing Address - Country:US
Mailing Address - Phone:724-757-6456
Mailing Address - Fax:
Practice Address - Street 1:407 CARPENTERTOWN MINE RD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-2912
Practice Address - Country:US
Practice Address - Phone:724-757-6456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP007401224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant