Provider Demographics
NPI:1831905447
Name:AUBIN, KENDRA CLARA (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:CLARA
Last Name:AUBIN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ALEXANDER ST
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-4652
Mailing Address - Country:US
Mailing Address - Phone:518-590-4135
Mailing Address - Fax:
Practice Address - Street 1:100 GLEN ST STE 3D
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4422
Practice Address - Country:US
Practice Address - Phone:518-223-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029749225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist