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Individual
KENNETH OMALLEY
Active
Individual
KENNETH OMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2117
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTR2117
OTR LICENSE
AR
Enumeration date
04/09/2013
Last updated
04/09/2013
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