Individual
KEZZIAH WANENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
8710 EMGE RD, PARKVILLE, MD 21234-3504
(410) 661-5955
Mailing address
1302 SUGARWOOD CIR, UNIT 202, BALTIMORE, MD 21221-5405
(443) 570-6239
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A01863
MD
Other
Enumeration date
02/27/2014
Last updated
02/27/2014
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