Provider Demographics
NPI:1245836220
Name:OGLE, KAITLYN B (MOTR/L)
Entity type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:B
Last Name:OGLE
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:MS
Other - First Name:KAITLYN
Other - Middle Name:B
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1112 MILL ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-3712
Mailing Address - Country:US
Mailing Address - Phone:803-432-4498
Mailing Address - Fax:803-432-2219
Practice Address - Street 1:1112 MILL ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-3712
Practice Address - Country:US
Practice Address - Phone:803-432-4448
Practice Address - Fax:803-432-2219
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation