Provider Demographics
NPI:1851847438
Name:KRONINGER, KAYLA (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:KRONINGER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3103
Mailing Address - Country:US
Mailing Address - Phone:614-940-8865
Mailing Address - Fax:
Practice Address - Street 1:309 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3103
Practice Address - Country:US
Practice Address - Phone:614-940-8865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006143A225X00000X
KY167597225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY167957OtherKENTUCKY OCCUPATIONAL THERAPY LICENSURE
IN31006143AOtherINDIANA OCCUPATIONAL THERAPY LICENSURE