MEDICARE: NADIA GLENN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OTA16469	FL
2	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1932606316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA GLENN

Provider Business Mailing Address
First Line	:	3437 NW 44TH ST APT 107
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33309-4272
Country	:	US
Telephone Number	:	954-348-4132
Fax Number	:

Provider Business Practice Location Address
First Line	:	3437 NW 44TH ST APT 107
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33309-4272
Country	:	US
Telephone Number	:	954-348-4132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2018
Last Update Date	:	12/22/2021

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Directions to “ NADIA GLENN ” Practice Location

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