Provider Demographics
NPI:1295907319
Name:GEHRING, KASANDRA KRAMER
Entity type:Individual
Prefix:
First Name:KASANDRA
Middle Name:KRAMER
Last Name:GEHRING
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 1:6859 TOWN HARBOUR BLVD APT 1411
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5083
Mailing Address - Country:US
Mailing Address - Phone:920-358-0506
Mailing Address - Fax:
Practice Address - Street 1:6859 TOWN HARBOUR BLVD APT 1411
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5083
Practice Address - Country:US
Practice Address - Phone:920-358-0506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3922-026225X00000X
FL14978222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist