Provider Demographics
NPI:1053878579
Name:COLE, KAYLEE MICHELLE (OT, MOT)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:MICHELLE
Last Name:COLE
Suffix:
Gender:F
Credentials:OT, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4915
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:18641 HIGHWAY 3235
Practice Address - Street 2:
Practice Address - City:GALLIANO
Practice Address - State:LA
Practice Address - Zip Code:70354-3936
Practice Address - Country:US
Practice Address - Phone:985-475-4555
Practice Address - Fax:985-475-4557
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA311940225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist