Individual
DR. JACQUELINE GRACE KETTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
150 VILLAGE CROSSING CT, SAINT AUGUSTINE, FL 32084-8697
(502) 694-5241
Mailing address
2121 GOLDEN LAKE LOOP, SAINT AUGUSTINE, FL 32084-5899
(417) 385-7650
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
23228
FL
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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