Provider Demographics
NPI:1053820134
Name:CULBERTSON, KAYLA T (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:T
Last Name:CULBERTSON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 S LOWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-1934
Mailing Address - Country:US
Mailing Address - Phone:303-885-9848
Mailing Address - Fax:303-200-7001
Practice Address - Street 1:172 S LOWELL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-1934
Practice Address - Country:US
Practice Address - Phone:734-778-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0006302225X00000X
MI5201009913225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist