Individual
KETTLIE EUGENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4191 OAK TERRACE DR, GREENACRES, FL 33463-3706
(561) 425-3177
Mailing address
4191 OAK TERRACE DR, GREENACRES, FL 33463-3706
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Enumeration date
02/15/2024
Last updated
02/29/2024
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