Individual
NANCY JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
5725 NW 186TH ST, HIALEAH, FL 33015-6019
(305) 625-9857
Mailing address
3400 NW 29TH ST APT 201, LAUDERDALE LAKES, FL 33311-1879
(754) 367-0044
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12102
FL
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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