Provider Demographics
NPI:1265242432
Name:YOUNG, KAITLIN (OTR/L)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 SHADY COVE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-7124
Mailing Address - Country:US
Mailing Address - Phone:401-365-8897
Mailing Address - Fax:
Practice Address - Street 1:55 SCALLOP SHELL WAY
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3045
Practice Address - Country:US
Practice Address - Phone:401-789-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01705225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist