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General NPI Number Information
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NPI Number | 1427619543
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Entity Type | Individual
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Provider Name | FELICIA GRAYBEAL OT
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Gender | Female
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 1804 OAKLEY SEAVER DR STE E
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City | CLERMONT
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State | FL
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Zip | 34711-1925
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Country | US
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Telephone | 813-381-4944
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Fax |
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Provider Business Mailing Address
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Address Line | 336 BROAD ST STE 203
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City | ROME
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State | GA
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Zip | 30161-3006
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Country | US
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Telephone | 813-381-4944
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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 | 420874
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | 420874
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT20073
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License Number State | FL
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