Individual
MRS. JENNIFER KINKADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
603 NW STANFORD LN, PORT SAINT LUCIE, FL 34983-3406
(772) 336-9357
Mailing address
603 NW STANFORD LN, PORT SAINT LUCIE, FL 34983-3406
(772) 336-9357
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT12294
FL
Other
Enumeration date
02/11/2007
Last updated
07/08/2007
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