Provider Demographics
NPI:1386124428
Name:PRICE, JAKAYLA NEKELLE (OTR, MOT)
Entity type:Individual
Prefix:MRS
First Name:JAKAYLA
Middle Name:NEKELLE
Last Name:PRICE
Suffix:
Gender:F
Credentials:OTR, MOT
Other - Prefix:
Other - First Name:JAKAYLA
Other - Middle Name:NEKELLE
Other - Last Name:BREWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3612 KITE LANDING LN.
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074
Mailing Address - Country:US
Mailing Address - Phone:903-244-7592
Mailing Address - Fax:
Practice Address - Street 1:3612 KITE LANDING LN.
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074
Practice Address - Country:US
Practice Address - Phone:903-244-7592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115570225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist