Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT19875 | FL |
NPI | 1003376278 |
---|---|
Provider Name | Reagan Kendall Garcia |
First Address | Bradenton, FL 34212-2505 |
Second Address | Sarasota, FL 34235-2618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2019 |
Last Update Date | 22/03/2019 |