Individual
KELSEY L DUFAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., OTR/L
Contact information
Practice address
17075 BUSHARD ST, FOUNTAIN VALLEY, CA 92708-2836
(855) 901-7742
(714) 962-4159
Mailing address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-7760
(704) 355-4326
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
15635
CA
Other
Enumeration date
09/24/2015
Last updated
08/14/2023
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