Provider Demographics
NPI:1336818053
Name:PAIVA, KAILEE
Entity type:Individual
Prefix:
First Name:KAILEE
Middle Name:
Last Name:PAIVA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 TURNPIKE RD APT 121
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2822
Mailing Address - Country:US
Mailing Address - Phone:203-400-7209
Mailing Address - Fax:
Practice Address - Street 1:44 BEARFOOT RD STE 150
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1562
Practice Address - Country:US
Practice Address - Phone:508-434-7444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA13911OtherMA STATE OTR/L LICENSE