Individual
KAYCIE FEGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
255 59TH ST N, ST PETERSBURG, FL 33710-8539
(727) 345-2775
Mailing address
1329 N WEMBLEY CIR, PORT ORANGE, FL 32128-3769
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA13153
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OTA13153
—
FL
Enumeration date
01/28/2019
Last updated
01/28/2019
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