Individual
LAKISHA SHERESE HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 OVERLOOK AVE APT 10K, HACKENSACK, NJ 07601-2236
(914) 564-3499
Mailing address
130 OVERLOOK AVE APT 10K, HACKENSACK, NJ 07601-2236
(914) 564-3499
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009405-1
NY
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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