Individual
MS. KELLY REGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA OTR/L
Contact information
Practice address
127 FOREST PARK AVE, SPRINGFIELD, MA 01108-2005
(860) 539-5571
Mailing address
127 FOREST PARK AVE, SPRINGFIELD, MA 01108-2005
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
9299
MA
225XP0200X
Pediatric Occupational Therapist
Primary
9299
MA
Other
Enumeration date
11/29/2006
Last updated
08/23/2009
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