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Individual

KETTIA NOEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1573 SE CLEARBROOK ST, PORT SAINT LUCIE, FL 34983-4050
(561) 503-3273
Mailing address
11582 SW VILLAGE PKWY, PORT SAINT LUCIE, FL 34987-2392
(772) 233-5976

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
L20000294693
FL
372600000X
Adult Companion
FL
376J00000X
Homemaker
237322
FL

Other

Enumeration date
10/30/2020
Last updated
03/04/2026
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