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Individual

KELLY EVAK

Active
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Individual

KELLY EVAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056014932
IL
225X00000X
Occupational Therapist
123612
TX
225X00000X
Occupational Therapist
Primary
7147
WI
225X00000X
Occupational Therapist
OT23926
FL
225X00000X
Occupational Therapist
OTH-009315
AZ

Other

Enumeration date
03/29/2024
Last updated
03/29/2024
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