Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | OT4950 | FL |
Y | 225XM0800X | Mental Health | OT4950 | FL |
NPI | 1619403110 |
---|---|
Provider Name | Ms. Arlene Vanessa Kinney |
First Address | Hallandale Beach, FL 33009-8903 |
Second Address | Hallandale Beach, FL 33009-8903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2017 |
Last Update Date | 19/05/2017 |