Individual
MRS. KELLY ANN SPENCER AYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1635 OHIO ST, WATERTOWN, NY 13601-3032
(315) 786-7285
Mailing address
179 ROCK ISLAND ST, GOUVERNEUR, NY 13642-1133
(315) 786-7285
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010503-01
NY
Other
Enumeration date
01/22/2026
Last updated
01/22/2026
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