Individual
MRS. KASSONDRA L MACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
17835 MURDOCK CIR, PORT CHARLOTTE, FL 33948-4000
(941) 625-6547
(941) 629-6415
Mailing address
17835 MURDOCK CIR, PORT CHARLOTTE, FL 33948-4000
(941) 625-6547
(941) 629-6415
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT11580
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z076F
BC/BS
FL
Enumeration date
09/27/2005
Last updated
07/08/2007
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