Basic Information
| Provider Information | |||||||||
| NPI: | 1972087385 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLTIS | ||||||||
| FirstName: | KAITLIN | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 73 TEN COAT LN | ||||||||
| Address2: | |||||||||
| City: | SHELTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064842287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2039069941 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10 WOODLAND DR | ||||||||
| Address2: | |||||||||
| City: | COVENTRY | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028166716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018262000 | ||||||||
| FaxNumber: | 4018262000 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2018 | ||||||||
| LastUpdateDate: | 03/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 222Q00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist |
No ID Information.