Individual
SHANICE LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
15291 NW 60TH AVE STE 101, MIAMI LAKES, FL 33014-2459
(305) 705-7702
Mailing address
3930 NW 176TH ST, MIAMI GARDENS, FL 33055-3842
(786) 859-2960
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17945
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OTA17945
—
FL
Enumeration date
09/05/2021
Last updated
09/06/2021
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