Individual
MRS. KELLY SUE WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA L
Contact information
Practice address
1942 OLD DEKALB RD, CANTON, NY 13617
(315) 386-3529
Mailing address
2 ALVERSON RD, HERMON, NY 13652
(315) 347-1381
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0060921
NY
Other
Enumeration date
12/01/2006
Last updated
05/23/2019
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