Individual
KENIESHA ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10825 NW 29TH MNR APT 4, SUNRISE, FL 33322-1023
(786) 704-5898
Mailing address
10825 NW 29TH MNR APT 4, SUNRISE, FL 33322
(786) 704-5898
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12500
FL
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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