Individual
KELLI BAGLEY MIERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
8961 YOUREE DR, SHREVEPORT, LA 71115-3001
(318) 671-8772
Mailing address
361 LINWOOD AVE, STONEWALL, LA 71078-9170
(318) 218-1772
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OOT.200499
LA
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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