Individual
MS. KACY YVETTE TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1311 SW 16TH ST, GAINESVILLE, FL 32608-1128
(352) 376-8821
Mailing address
1173 RIVERSIDE TER, GAINESVILLE, GA 30501-1735
(770) 536-9573
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003586
GA
225X00000X
Occupational Therapist
OT13155
FL
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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