Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kayla Marie Prom

Individual provider Occupational Therapy Assistant · NPI 1164918504

Kayla Marie Prom is an Occupational Therapy Assistant in Mayville, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2018.

Licensed in
WI
In the registry since
2018

Practice location Address checks out

305 S Clark St
Mayville, WI 53050-1488
Phone: (920) 387-0354
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 5467-27 (WI)

Record details

NPI number1164918504
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 9, 2018
Last updated in NPPESJuly 9, 2018

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