Individual provider · Type 1 NPI

Kiley Petencin

Occupational Therapist · Idaho Falls, ID

NPI number 1639810823 Active

Practice location

1460 Elk Creek Dr
Idaho Falls, ID 83404-8237

Call (208) 535-1286 Map

Mailing address

197 E 19th St
Idaho Falls, ID 83404-6020

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000XOT-1736 (ID)
Occupational Therapist 225X00000X379227 (OR)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1639810823

Kiley Petencin's National Provider Identifier is 1639810823, issued on Apr 5, 2022. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Idaho Falls, ID. The record was last updated on Jul 27, 2026.