Provider Demographics
NPI:1013307313
Name:KAIL, KAELEE RAE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KAELEE
Middle Name:RAE
Last Name:KAIL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:KAELEE
Other - Middle Name:RAE
Other - Last Name:KENDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2617 PENDLETON DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-1786
Mailing Address - Country:US
Mailing Address - Phone:651-238-9487
Mailing Address - Fax:
Practice Address - Street 1:17480 DALLAS PKWY # 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287
Practice Address - Country:US
Practice Address - Phone:469-291-8500
Practice Address - Fax:214-547-7328
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076166225X00000X
TX119951225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist