Individual
KELLEA DEMILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSC
Contact information
Practice address
2100 E MARTIN LUTHER KING JR BLVD, AUSTIN, TX 78702-1342
(512) 900-7934
Mailing address
9603 AUTUMNWOOD PL, HIGHLANDS RANCH, CO 80129-5776
(512) 705-1259
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0008240
CO
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000
—
TX
Enumeration date
02/28/2020
Last updated
11/13/2023
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