Kaelin Deanna Gulla, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Burlington, KY
NPI 1164054573 · NPPES record last updated Feb 4, 2020
Key facts
- NPI
- 1164054573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 165360 (KY)
- Practice address
- 2259 Bluegrama Dr
Burlington, KY 41005-6801 - Phone
- (317) 908-1488
- NPI assigned
- Feb 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 165360 | KY | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant |
224Z00000X | 165360 | KY | Yes |
Addresses
Primary practice location
2259 Bluegrama Dr
Burlington, KY 41005-6801
Mailing address
2259 Bluegrama Dr
Burlington, KY 41005-6801
Phone (317) 908-1488
Other providers in Burlington, KY
- Douglas Charles Fussinger
- Elizabeth Gough
- Stacey N Gripshover
- Renee Grote
- Joseph M Grzelak IV
- Hart Healthcare, PLLC
- Dana Rochelle Hays
- Jennifer S Hoffman
- Homan Chiropractic Inc
- Joanna Hopper
All providers in Burlington, KY · Occupational Therapy Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.