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Organization

LKPRESS-OTR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. WENDY L KELLER MA, MCM, OTR/L (OCCUPATIONAL THERAPIST)
(661) 714-1455
Entity
Organization

Contact information

Practice address
1216 N BRAND BLVD APT 6, GLENDALE, CA 91202-1947
(661) 714-1455
Mailing address
1216 N BRAND BLVD APT 6, GLENDALE, CA 91202-1947
(661) 714-1455

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10496
CA
252Y00000X
Early Intervention Provider Agency
10496
CA
332BC3200X
Customized Equipment (DME)

Other

Enumeration date
08/19/2014
Last updated
08/19/2014
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