Individual
NAKEISHA KELANI VAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
850 NW FEDERAL HWY STE 173, STUART, FL 34994-1019
(954) 579-7973
Mailing address
4011 NW 187TH ST, MIAMI GARDENS, FL 33055-2718
(786) 616-9274
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/02/2024
Last updated
07/29/2024
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