Individual
KELSEY TILLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
118715
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118715
TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS
TX
Enumeration date
03/06/2019
Last updated
03/06/2019
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