Individual provider · NPI-1

Charlene Antonacci, MS OTR/L

Occupational Therapist · Hollywood, FL

NPI number1265804694
StatusActive
Last updated in NPPESOct 26, 2015

Details

NPI
1265804694
Entity type
Individual (NPI-1)
Name
Charlene Antonacci
Credential
MS OTR/L
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 26, 2015
Last updated
Oct 26, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational TherapistOT15530FLYes

Practice location

12107 Park Dr
Hollywood, FL 33026-1017

Phone 954-450-2799

Mailing address

12107 Park Dr
Hollywood, FL 33026-1017

Phone 954-450-2799

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