Individual
MRS. KAIDRA QUANTAI THONPKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 THISTLE TRL, HAWTHONRE, FL 32604
(352) 301-1271
Mailing address
118 THISTLE TRL, HAWTHORNE, FL 32640-5810
(352) 301-1271
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
L19000048624
FL
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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