Individual provider · NPI-1

Kettlie Eugene

Developmental Therapist · Greenacres, FL

NPI number1124883491
StatusActive
Last updated in NPPESFeb 29, 2024

Details

NPI
1124883491
Entity type
Individual (NPI-1)
Name
Kettlie Eugene
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 15, 2024
Certification date
Feb 29, 2024
Last updated
Feb 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
222Q00000X Developmental Therapist–FLYes

Other names

  • Kettlie Monfleury (Other Name)

Practice location

4191 Oak Terrace Dr
Greenacres, FL 33463-3706

Phone 561-425-3177

Mailing address

4191 Oak Terrace Dr
Greenacres, FL 33463-3706

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