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Individual

KAYLA R RIEGEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD, OTR/L, C-GCM

Contact information

Practice address
30070 STATE ROAD 56, WESLEY CHAPEL, FL 33543-7628
(570) 573-2586
Mailing address
1722 E RIVER COVE ST, TAMPA, FL 33604-3553
(570) 573-2586

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
07315
MD
225X00000X
Occupational Therapist
Primary
22376
FL
225X00000X
Occupational Therapist
22569
CA
225X00000X
Occupational Therapist
OC010177
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13510734
CAQH
PA
Enumeration date
01/19/2010
Last updated
12/04/2021
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