Healthcare Provider Details

I. General information

NPI: 1619403110
Provider Name (Legal Business Name): ARLENE VANESSA KINNEY OTR/L MED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 05/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PARKVIEW DR APT 615
HALLANDALE BEACH FL
33009-8903
US

IV. Provider business mailing address

800 PARKVIEW DR APT 615
HALLANDALE BEACH FL
33009-8903
US

V. Phone/Fax

Practice location:
  • Phone: 786-493-6266
  • Fax:
Mailing address:
  • Phone: 786-493-6266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOT4950
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License NumberOT4950
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: