Provider Demographics
NPI:1851038210
Name:TODD, MAKAYLA ELIZABETH MAE (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:MAKAYLA
Middle Name:ELIZABETH MAE
Last Name:TODD
Suffix:
Gender:F
Credentials:OTR/L
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Mailing Address - Street 1:1107 SOULARD ST APT C
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-3451
Mailing Address - Country:US
Mailing Address - Phone:574-309-7973
Mailing Address - Fax:
Practice Address - Street 1:3720 CHURCH ROCK ST
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-4572
Practice Address - Country:US
Practice Address - Phone:505-722-2261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMOT-2025-0013225X00000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist