Individual
BEULAH KELLYWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1300 CAMINO SIERRA VIS, SANTA FE, NM 87505-1007
(505) 467-2504
(505) 467-2504
Mailing address
PO BOX 93894, ALBUQUERQUE, NM 87199-3894
(505) 467-2504
(505) 467-2504
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2200
NM
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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