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NPI Code Detail

MEDICARE: KAYLA BRIANNE HARRISON MS, OTR/L

MEDICARE: KAYLA BRIANNE HARRISON MS, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist19595FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629545496
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA BRIANNE HARRISON MS, OTR/L
Provider Business Mailing Address
First Line : 2201 SW 28TH ST APT 64
Second Line :
City : OKEECHOBEE
State : FL
Zip : 34974-5788
Country : US
Telephone Number : 863-697-6832
Fax Number :
Provider Business Practice Location Address
First Line : 4715 KIRBY LOOP RD
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5345
Country : US
Telephone Number : 772-577-6964
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2018
Last Update Date : 10/30/2018

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