Individual
PAULNEQUA FONGKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 PARK PLACE BLVD, KISSIMMEE, FL 34741-2373
(800) 378-7597
Mailing address
3630 WEATHERFIELD DR, KISSIMMEE, FL 34746-2847
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
02/25/2018
Last updated
02/25/2018
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