Individual
KERRY M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202002319
MI
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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