NPI 1003160672

Khallilah Gonsalves, COTA

Practitioner Occupational Therapy Assistant Davie, FL

Practice location

Address: 6641 W Wedgewood Ave, Davie, FL 33331-2915
Phone: (954) 618-7333

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence 11778 (FL)

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Registry record

NPI: 1003160672
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Nov 2012
Record last updated: 5 Nov 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.