Provider Demographics
NPI:1881085009
Name:PICKETT, KAITLIN STEPHANIE (DPT, ATC)
Entity type:Individual
Prefix:MRS
First Name:KAITLIN
Middle Name:STEPHANIE
Last Name:PICKETT
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5907 ARGERIAN DR
Mailing Address - Street 2:101
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4237
Mailing Address - Country:US
Mailing Address - Phone:813-907-0548
Mailing Address - Fax:813-991-9706
Practice Address - Street 1:5907 ARGERIAN DR
Practice Address - Street 2:101
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4237
Practice Address - Country:US
Practice Address - Phone:813-907-0548
Practice Address - Fax:813-991-9706
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT30094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist