Individual
STEPHANIE ETIENVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1408 W BRANCH ST, LANTANA, FL 33462
(561) 674-3381
Mailing address
1408 W BRANCH ST, LANTANA, FL 33462
(561) 674-3381
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
06/27/2024
Last updated
07/15/2024
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