Individual
MISS GISELLE ALEJANDRA THEVENIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2040 NE 163RD ST, SUITE 306, NORTH MIAMI BEACH, FL 33162-4951
(786) 306-9562
(954) 966-6412
Mailing address
19499 NE 10TH AVE, APT 304, MIAMI, FL 33179-5732
(786) 262-3729
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
10684
FL
Other
Enumeration date
06/06/2008
Last updated
05/02/2014
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