Individual
MANOUCHEKA S DEZINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 NW 183RD ST STE 404, MIAMI, FL 33169-4619
(305) 735-1340
Mailing address
3015 NW 30TH WAY, LAUDERDALE LAKES, FL 33311-8497
(305) 735-1340
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ISW8528
FL
Other
Enumeration date
04/08/2021
Last updated
05/21/2021
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