Individual
KELLIE GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
863 HATHAWAY RD, NEW BEDFORD, MA 02740-1916
(508) 996-6763
Mailing address
142 FERNCROFT RD, SOMERSET, MA 02726-2412
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
01776
RI
225X00000X
Occupational Therapist
Primary
11267
MA
Other
Enumeration date
08/06/2018
Last updated
01/04/2022
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