Individual
MRS. KELLY ANN GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1204 GREENSBURG ST, COLUMBIA, KY 42728-1811
(270) 384-2476
Mailing address
101 BLUEGRASS DR, COLUMBIA, KY 42728-1735
(270) 805-7172
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
137187
KY
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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