Individual
KAILEY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
145 MIDDLE ST STE 1101, LAKE MARY, FL 32746-3594
(407) 323-6955
(407) 323-4564
Mailing address
145 MIDDLE ST STE 1101, LAKE MARY, FL 32746-3594
(407) 323-6955
(407) 323-4564
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17721
FL
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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