Provider Demographics
NPI:1396061016
Name:KAHL, JADA (MSOTR/L)
Entity type:Individual
Prefix:MRS
First Name:JADA
Middle Name:
Last Name:KAHL
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 EAGLE RUN
Mailing Address - Street 2:
Mailing Address - City:DELL RAPIDS
Mailing Address - State:SD
Mailing Address - Zip Code:57022-2142
Mailing Address - Country:US
Mailing Address - Phone:605-321-2428
Mailing Address - Fax:
Practice Address - Street 1:300 22ND AVE
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-2480
Practice Address - Country:US
Practice Address - Phone:605-696-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1967225X00000X
SD0713225X00000X
MN103558225X00000X
IA001876225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist