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General NPI Number Information
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NPI Number | 1376948729
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Entity Type | Individual
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Provider Name | MRS. NALEENEE TRADER
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Gender | Female
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 3091 NW 43RD ST
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33309-4310
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Country | US
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Telephone | 954-777-5167
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Fax | 954-733-1167
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Provider Business Mailing Address
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Address Line | 3091 NW 43RD ST
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33309-4310
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Country | US
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Telephone | 954-777-5167
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Fax | 954-733-1167
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL10631
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License Number State | FL
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