Provider Demographics
NPI:1275928202
Name:ARMIGER, KASEY RYAN (COTA/L)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:RYAN
Last Name:ARMIGER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:RYAN
Other - Last Name:SHROYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:460 RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9504
Mailing Address - Country:US
Mailing Address - Phone:321-303-9864
Mailing Address - Fax:
Practice Address - Street 1:460 RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9504
Practice Address - Country:US
Practice Address - Phone:321-303-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14407225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty