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Individual

KELLY C MAYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100
Mailing address
1000 EDDY ST, PROVIDENCE, RI 02905-4739
(401) 533-9100

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT01035
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2058
SS NHPRC
RI
01
412369
SS BCHIP
RI
01
6400144
SS UHP
RI
01
99947
SS BCROSS
RI
Enumeration date
07/03/2006
Last updated
04/09/2008
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