Individual
KELLEY PACILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1412 N BRINDLEE MOUNTAIN PKWY, ARAB, AL 35016-5431
(256) 931-2013
(256) 931-2014
Mailing address
251 JOHNSTON ST SE STE 300, DECATUR, AL 35601-2515
(256) 340-9708
(256) 340-9624
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3961
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003819608
GROUP NPI
AL
05
—
529917620
—
AL
Enumeration date
03/04/2015
Last updated
05/07/2015
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