Individual
MS. KELLY MC KENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTRL
Contact information
Practice address
14 RESEARCH WAY, EAST SETAUKET, NY 11733-3453
(631) 331-6400
Mailing address
33 MOSBY DR, LAKE GROVE, NY 11755-2316
(631) 588-3519
(631) 588-3519
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
010723-1
NY
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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