Healthcare Provider Details

I. General information

NPI: 1164072864
Provider Name (Legal Business Name): S&K THERAPEUTIC ALLIANCE AND CONSULTANT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2019
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15930 NW 38TH CT
OPA LOCKA FL
33054-6720
US

IV. Provider business mailing address

15930 NW 38TH CT
OPA LOCKA FL
33054-6720
US

V. Phone/Fax

Practice location:
  • Phone: 786-626-7668
  • Fax:
Mailing address:
  • Phone: 786-626-7668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SHEREE OO
Title or Position: CLINICAL DIRECTOR
Credential: MSW
Phone: 786-626-7668