Provider Demographics
NPI:1821027715
Name:STENNETT, CHARLEEN A (OT)
Entity Type:Individual
Prefix:
First Name:CHARLEEN
Middle Name:A
Last Name:STENNETT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8905 SW 87TH AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2227
Mailing Address - Country:US
Mailing Address - Phone:305-667-8686
Mailing Address - Fax:305-412-2356
Practice Address - Street 1:8905 SW 87TH AVE
Practice Address - Street 2:STE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2227
Practice Address - Country:US
Practice Address - Phone:305-667-8686
Practice Address - Fax:305-412-2356
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT5498174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1031100307OtherCERTIFIED HAND THERAPIST