Individual
KELLY LYNN OUELLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
15100 WHITTAKER WAY, GRAND HAVEN, MI 49417-8696
(616) 935-6280
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010533
MI
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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