Individual
KEILY LARGACHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3201 BUDINGER AVE, SAINT CLOUD, FL 34769-7203
(407) 891-3082
Mailing address
2608 COLDSTREAM CT, KISSIMMEE, FL 34743-5659
(407) 738-3465
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12537
FL
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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