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Individual
MS. KELLY HALL
Active
Individual
MS. KELLY HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1067264
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1067264
LICENSE NUMBER
OR
Enumeration date
07/23/2009
Last updated
07/23/2009
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