Provider Demographics
NPI:1740657873
Name:BAUMGARTEN, KAILA (OTR/L)
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:
Last Name:BAUMGARTEN
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 1:1955 SE OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8211
Mailing Address - Country:US
Mailing Address - Phone:563-513-7233
Mailing Address - Fax:
Practice Address - Street 1:2602 FIFIELD RD
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-7925
Practice Address - Country:US
Practice Address - Phone:641-458-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA079026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist