Provider Demographics
NPI:1679021760
Name:PERKINSON, KAYLA NICOLE (OTR)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:NICOLE
Last Name:PERKINSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5314 W FRIENDLY AVE STE E
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-4351
Mailing Address - Country:US
Mailing Address - Phone:336-285-7324
Mailing Address - Fax:336-579-0693
Practice Address - Street 1:5314 W FRIENDLY AVE STE E
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4351
Practice Address - Country:US
Practice Address - Phone:336-285-7324
Practice Address - Fax:336-579-0693
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9121225XF0002X, 225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics