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General NPI Number Information
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NPI Number | 1003167347
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Entity Type | Individual
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Provider Name | LAURIE A. CECIL OTD, OTR/L, DRP
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Gender | Female
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 1536 N JEFFERSON ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6525
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Country | US
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Telephone | 904-475-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 146 BOULDER ROCK DR
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City | PALM COAST
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State | FL
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Zip | 32137-8533
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Country | US
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Telephone | 908-400-9757
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1772
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License Number State | FL
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