Provider Demographics
NPI:1932670726
Name:TURNER, KAYLYN RENEE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KAYLYN
Middle Name:RENEE
Last Name:TURNER
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 1:4823 IMPERIAL TER
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-2363
Mailing Address - Country:US
Mailing Address - Phone:502-472-2720
Mailing Address - Fax:
Practice Address - Street 1:4823 IMPERIAL TER
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2363
Practice Address - Country:US
Practice Address - Phone:502-472-2720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2019-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY246117224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant