Provider Demographics
NPI:1023994027
Name:COLEMAN, KAYLA BROOKE (MOT, LOTR)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:BROOKE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MOT, LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13564 PRAIRIE LN
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-5634
Mailing Address - Country:US
Mailing Address - Phone:225-788-8917
Mailing Address - Fax:
Practice Address - Street 1:37278 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3487
Practice Address - Country:US
Practice Address - Phone:225-744-1717
Practice Address - Fax:225-744-1718
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA348188225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist