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Individual
KELLY MCCLINTOCK
Active
Individual
KELLY MCCLINTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
05171
MD
225X00000X
Occupational Therapist
OC007194L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101421547
MA
PA
Enumeration date
09/20/2007
Last updated
10/17/2022
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