Individual
KELLI CLAIRE MACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
440 CENTRAL AVE, LEXINGTON, NC 27292-2634
(336) 236-6546
Mailing address
PO BOX 587, LEXINGTON, NC 27293-0587
(336) 236-6546
(336) 236-9546
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7337
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68681
BCBSNC
NC
05
—
7211679
—
NC
Enumeration date
10/28/2009
Last updated
10/28/2009
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