Individual
KAYLA ALISE ALSUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3865 TAMPA RD, OLDSMAR, FL 34677-3008
(813) 855-4661
Mailing address
3005 FONTANAR ST, LUTZ, FL 33558-4944
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTA15678
FL
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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