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General NPI Number Information
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NPI Number | 1396909925
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Entity Type | Individual
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Provider Name | KAROLINE KNEZEVICH OTR/L06/18/1953
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Gender | Female
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Dates
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Enumeration Date | 07/13/2008
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Last Update Date | 07/13/2008
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Provider Practice Location Address
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Address Line | 3650 MANSELL RD SUITE 300
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City | ALPHARETTA
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State | GA
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Zip | 30022-3012
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Country | US
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Telephone | 877-896-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 2144 WALLINGFORD ST
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City | DELTONA
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State | FL
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Zip | 32738-6613
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Country | US
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Telephone | 386-574-1235
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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 | OT 11944
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License Number State | FL
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