DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KENNETH CHARLES DEAN, COTA/L

Active Sole Proprietor

Gerontology Occupational Therapist · SHREVEPORT, LA

Registration Details

NPI Number
1184188435
Provider Type
Individual
Gender
Male
NPI Issued
Jan 30, 2019 (7.2231847852705 yrs)
Last Updated
Jan 30, 2019
License
214817 (TX)
Sole Proprietor
Yes

Practice Information

Address
8924 BAYONNE DR
SHREVEPORT, LA, 711182033
Browse LA providers · Browse ZIP 71118
Phone
3182941952
Primary Specialty
Gerontology Occupational Therapist
225XG0600X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.