Provider Demographics
NPI:1053951699
Name:COOK, KAYLA (MOT OTR/L)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:MOT OTR/L
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:WOODRUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15394 RITCHIE AVE NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49319-8520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1899 TATE BLVD SE STE 2106
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4200
Practice Address - Country:US
Practice Address - Phone:828-358-0976
Practice Address - Fax:828-838-1057
Is Sole Proprietor?:No
Enumeration Date:2020-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13307225X00000X
MI5201010626225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist