Individual
KAITLYN NICOLE KALISZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
31 STAFFORD AVE, STAFFORD, VA 22554-7246
(540) 658-6000
Mailing address
43 MUSTER DR, STAFFORD, VA 22554-8503
(540) 272-8106
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007379
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119007379
STATE LICENSE
VA
Enumeration date
07/12/2017
Last updated
07/04/2019
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