Individual
LAURA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E FERGUSON ST STE 608, TYLER, TX 75702-5756
(903) 705-0070
Mailing address
4411 KINSEY DR APT 931, TYLER, TX 75703-1021
(985) 285-4380
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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