Individual
ALICE M ENAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
250 AVENUE K. SW, SUITE 200, WINTER HAVEN, FL 33880-3919
(863) 297-5400
(863) 293-8230
Mailing address
250 AVENUE K. SW, SUITE 200, WINTER HAVEN, FL 33880-3919
(863) 297-5400
(863) 293-8230
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT8245
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z043T
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
10/04/2005
Last updated
09/27/2010
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