Provider Demographics
NPI:1043930969
Name:VINCETT, KACEE REBECCA
Entity Type:Individual
Prefix:
First Name:KACEE
Middle Name:REBECCA
Last Name:VINCETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 DELANEY ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6231
Mailing Address - Country:US
Mailing Address - Phone:321-626-3674
Mailing Address - Fax:
Practice Address - Street 1:3020 DELANEY ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6231
Practice Address - Country:US
Practice Address - Phone:321-626-3674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11285235Z00000X
CA33984235Z00000X
MD10117235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist