Individual
KATHRYN KINCANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1550 JESS PARRISH CT, TITUSVILLE, FL 32796-2147
(321) 269-1894
Mailing address
1427 HAMPTON PARK LN, MELBOURNE, FL 32940-8145
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11230
FL
Other
Enumeration date
01/14/2012
Last updated
01/14/2012
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