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Organization
KENISHA ROTIBI
Active
Organization
KENISHA ROTIBI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENISHA ROTIBI (OWNER)
(972) 890-6101
Entity
Organization
Contact information
Practice address
5963 RIDGEWAY DR, GRAND PRAIRIE, TX 75052-0444
(972) 890-6101
Mailing address
5963 RIDGEWAY DR, GRAND PRAIRIE, TX 75052-0444
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
05/04/2023
Last updated
05/05/2023
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