Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT19395 | FL |
NPI | 1184236242 |
---|---|
Provider Name | Michelle Lenore Lesnick |
First Address | Hallandale Beach, FL 33009-2966 |
Second Address | Hallandale Beach, FL 33009-2966 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2020 |
Last Update Date | 20/08/2020 |