Individual
BRINA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 PLEASANT AVE, PORTLAND, ME 04103-3218
(207) 939-1113
Mailing address
10 PLEASANT AVE, PORTLAND, ME 04103-3218
(207) 939-1113
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3745
ME
Other
Enumeration date
01/08/2020
Last updated
05/09/2020
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