Individual
KAYLA BETH BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1040 PILGRIM WAY, GREEN BAY, WI 54304-5028
(920) 499-1481
Mailing address
1040 PILGRIM WAY, GREEN BAY, WI 54304-5028
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6209-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
08/31/2018
Last updated
08/31/2018
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