Individual
ICLEIA NYARI BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10368 PANAMA ST, HOLLYWOOD, FL 33026-4529
(954) 821-3547
Mailing address
10368 PANAMA ST, HOLLYWOOD, FL 33026-4529
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 12314
FL
Other
Enumeration date
12/21/2013
Last updated
12/21/2013
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