Individual
MISS JENAE NICOLE STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT.
Contact information
Practice address
10661 NW 14TH ST, #232, PLANTATION, FL 33322-6971
(954) 661-1788
Mailing address
10661 NW 14TH ST, #232, PLANTATION, FL 33322-6971
(954) 661-1788
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA48030
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA48030
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
09/08/2009
Last updated
09/08/2009
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