Provider Demographics
NPI:1023856226
Name:VALLEE, KASEY MCKENZIE (OTR/L)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:MCKENZIE
Last Name:VALLEE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 LAUREL HILL RD APT 12B
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-7220
Mailing Address - Country:US
Mailing Address - Phone:413-770-6402
Mailing Address - Fax:
Practice Address - Street 1:14 CLARA DR
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-1973
Practice Address - Country:US
Practice Address - Phone:860-245-0851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-20
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6438225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist