India Brooke Kahle, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Stuart, VA
NPI 1639932395 · NPPES record last updated Feb 5, 2024
Key facts
- NPI
- 1639932395
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 0131002804 (VA)
- Practice address
- 132 N Main Street
Stuart, VA 24171 - Phone
- (276) 694-3163
- NPI assigned
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 15521 | NC | MD | Occupational Therapy Assistant |
| 0131002804 | VA | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 15521 | NC | |
| Occupational Therapy Assistant | 224Z00000X | 0131002804 | VA | Yes |
Addresses
Primary practice location
132 N Main Street
Stuart, VA 24171
Mailing address
198 Rye Cove Creek Rd
Stuart, VA 24171-3518
Phone (276) 229-8693
Other providers in Stuart, VA
- Gregory Todd Hutchens
- Jeb Stuart Rescue Squad Incorporated
- Teresa Jetmar
- Shonda Jones
- Milbourne L Joye Jr.
- Kam'S Corner, LLC
- Noel P Kornett
- Ralph Lewis Kramer
- Landmark Alf Operations LLC
- Landmark Transport LLC
All providers in Stuart, VA · Occupational Therapy Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2024. 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.