Provider Demographics
NPI:1740737378
Name:BELANGER, KAYLA (DPT)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:BELANGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 AUBURN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2141
Mailing Address - Country:US
Mailing Address - Phone:207-797-7578
Mailing Address - Fax:207-797-8165
Practice Address - Street 1:94 AUBURN ST STE 103
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2141
Practice Address - Country:US
Practice Address - Phone:207-797-7578
Practice Address - Fax:207-797-8165
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11126225100000X
MEPT6734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist