Individual
KELLY VARNADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2909 HAWKSTON ST, JEFFERSON, LA 70121-2721
(504) 920-8265
Mailing address
2909 HAWKSTON ST, JEFFERSON, LA 70121-2721
(504) 920-8265
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
113919
TX
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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