Provider Demographics
NPI:1437575479
Name:CARDARELLI, KACY PEARMAN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KACY
Middle Name:PEARMAN
Last Name:CARDARELLI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 JETS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-3250
Mailing Address - Country:US
Mailing Address - Phone:864-378-4696
Mailing Address - Fax:
Practice Address - Street 1:436 JETS LANDING RD
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-3250
Practice Address - Country:US
Practice Address - Phone:864-378-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-14
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4182225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist