Provider Demographics
NPI:1932416849
Name:KRISHNAN, KAVITHA N (OTD MS OTR/L)
Entity Type:Individual
Prefix:DR
First Name:KAVITHA
Middle Name:N
Last Name:KRISHNAN
Suffix:
Gender:F
Credentials:OTD MS OTR/L
Other - Prefix:
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Mailing Address - Street 1:3836 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27525-7011
Mailing Address - Country:US
Mailing Address - Phone:919-327-0932
Mailing Address - Fax:919-578-1504
Practice Address - Street 1:3836 IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:NC
Practice Address - Zip Code:27525-7011
Practice Address - Country:US
Practice Address - Phone:919-327-0932
Practice Address - Fax:919-578-1504
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL056008405225XP0200X
NC1612068225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty