Individual
KAYLIE DINNING EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3452 LAKE LYNDA DR STE 200, ORLANDO, FL 32817-1481
(800) 774-7785
Mailing address
14183 MARK ST, GONZALES, LA 70737-5987
(225) 485-6158
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OTR-1331
WY
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117899
OT LICENSE
TX
Enumeration date
04/09/2018
Last updated
05/01/2018
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