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Individual

KAITLYN WYCUFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
112 W CITRUS ST, ALTAMONTE SPRINGS, FL 32714-2502
(407) 865-5646
Mailing address
307 MANOR VIEW LN, DELAND, FL 32724-7740
(386) 801-7624

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
16275
FL
225XP0200X
Pediatric Occupational Therapist
16275
FL

Other

Enumeration date
01/09/2018
Last updated
10/26/2018
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