Individual
COLLEEN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
130 LOMOND CT, UTICA, NY 13502-5957
(315) 724-4286
Mailing address
PO BOX 542, HEUVELTON, NY 13654-0542
(315) 854-7243
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006513-1
NY
Other
Enumeration date
12/15/2019
Last updated
12/15/2019
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