Provider Demographics
NPI:1508348269
Name:FRANTZ, KAITLIN MARIE (OT)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:MARIE
Last Name:FRANTZ
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:MARIE
Other - Last Name:ENSULO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2832 1ST ST
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1502
Mailing Address - Country:US
Mailing Address - Phone:860-287-2440
Mailing Address - Fax:
Practice Address - Street 1:4000 RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3149
Practice Address - Country:US
Practice Address - Phone:610-891-3613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004656225X00000X
PAOC015442225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist