Provider Demographics
NPI:1477008993
Name:KINGCADE, ALYCIA
Entity Type:Individual
Prefix:
First Name:ALYCIA
Middle Name:
Last Name:KINGCADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALYCIA
Other - Middle Name:LYN
Other - Last Name:KINGCADE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7652 STANWICK CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9560
Mailing Address - Country:US
Mailing Address - Phone:614-940-1213
Mailing Address - Fax:
Practice Address - Street 1:7652 STANWICK CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9560
Practice Address - Country:US
Practice Address - Phone:614-940-1213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer