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Individual

KELLEY PHILLIPS KOZLOFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, OTRL

Contact information

Practice address
115 MILL ST, BELMONT, MA 02478-1041
(617) 855-2847
Mailing address
82 LOWELL ST, APARTMENT 1, SOMERVILLE, MA 02143-2417
(248) 506-3109

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
AH8943-OT
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AH 8943-OT
OCCUPATIONAL THERAPY LICE
MA
Enumeration date
01/02/2007
Last updated
07/08/2007
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