Individual
KAYLEE JAYANNE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
1051 JOHNNIE DODDS BLVD STE G, MOUNT PLEASANT, SC 29464-3100
(828) 778-8333
Mailing address
1305 CAROL OAKS DR, MOUNT PLEASANT, SC 29466-6501
(423) 388-5198
(888) 443-6471
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT5489
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7838
—
SC
Enumeration date
02/26/2019
Last updated
02/26/2019
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