Provider Demographics
NPI:1639539950
Name:CARLIN, KAITLYNN LILLIAN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KAITLYNN
Middle Name:LILLIAN
Last Name:CARLIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KAITLYNN
Other - Middle Name:LILLIAN
Other - Last Name:BORETSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1280 HORSESHOE BND
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7404
Mailing Address - Country:US
Mailing Address - Phone:203-444-9530
Mailing Address - Fax:
Practice Address - Street 1:109 BEE ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-5703
Practice Address - Country:US
Practice Address - Phone:843-577-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC014331225X00000X
SC5132225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist