Individual
NINA ALYSSA SYAHEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4533
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3944319907
—
NM
Enumeration date
09/09/2021
Last updated
09/09/2021
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