Individual
MISS KANISHA SHUNTA ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2808 72ND ST W, LEHIGH ACRES, FL 33971-5824
(239) 529-0520
Mailing address
2808 72ND ST W, LEHIGH ACRES, FL 33971-5824
(239) 529-0520
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
07/07/2020
Last updated
04/07/2025
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