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1003160672
KHALLILAH GONSALVES
DAVIE, FL
NPI
1003160672
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: FL 11778)
Enumeration Date
2012-11-05
Last Update Date
2012-11-05
Business Address
-- KHALLILAH GONSALVES COTA
6641 W WEDGEWOOD AVE
DAVIE, FL 33331-2915
Phone number: 954-618-7333
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Mailing Address
-- KHALLILAH GONSALVES COTA
6641 W WEDGEWOOD AVE
DAVIE, FL 33331-2915
Phone number: 954-618-7333
Copy
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