Provider Demographics
NPI:1316515604
Name:COUTINHO, KAITLEN (DPT)
Entity type:Individual
Prefix:
First Name:KAITLEN
Middle Name:
Last Name:COUTINHO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAITLEN
Other - Middle Name:
Other - Last Name:GODDARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3341 S ELM PL
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-7924
Mailing Address - Country:US
Mailing Address - Phone:918-449-1332
Mailing Address - Fax:
Practice Address - Street 1:2601 N ASPEN AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1373
Practice Address - Country:US
Practice Address - Phone:918-486-9977
Practice Address - Fax:539-777-2529
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist