Provider Demographics
NPI:1548902554
Name:NEAL, KAYLA MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:NEAL
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 1:209 ROOT RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-9801
Mailing Address - Country:US
Mailing Address - Phone:413-568-3942
Mailing Address - Fax:
Practice Address - Street 1:209 ROOT RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-9801
Practice Address - Country:US
Practice Address - Phone:413-568-3942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5051225X00000X
MA13004225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist