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General NPI Number Information
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NPI Number | 1053136622
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Entity Type | Individual
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Provider Name | KASEY ANN KIGHT OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 111 12TH ST E
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City | TIFTON
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State | GA
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Zip | 31794-4007
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Country | US
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Telephone | 229-652-5650
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Fax | 229-652-5642
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Provider Business Mailing Address
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Address Line | 200 W MOORE ST DBA VALDOSTA PEDIATRIC THERAPY SERVICES
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City | VALDOSTA
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State | GA
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Zip | 31602-2919
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Country | US
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Telephone | 229-253-8500
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Fax | 229-253-8522
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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 | OT009379
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License Number State | GA
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