Individual
JENNY LICOR BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9425 SW 72ND ST STE 225, MIAMI, FL 33173-5494
(786) 953-8389
Mailing address
222 E 37TH ST, HIALEAH, FL 33013-2646
(786) 325-1272
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
20222
FL
Other
Enumeration date
08/06/2019
Last updated
10/06/2023
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