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General NPI Number Information
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NPI Number | 1346936523
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Entity Type | Organization
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Legal Business Name | KAYCO THERAPY, LLC
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 2735 N HOLLAND SYLVANIA RD
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City | TOLEDO
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State | OH
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Zip | 43615-1846
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Country | US
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Telephone | 419-707-9792
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Fax |
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Provider Business Mailing Address
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Address Line | 12331 WATERSTONE LN APT 723
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City | PERRYSBURG
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State | OH
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Zip | 43551-3046
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Country | US
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Telephone | 419-707-9792
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | KASEY CHARLOTTE O'NEAL
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Credential | MSW, LISW, ACHT
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Telephone | 419-707-9792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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