Individual
KELLEY KYRENE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
313 N. HURSTBOURNE PARKWAY, SUITE 211, LOUISVILLE, KY 41222
(512) 412-5847
Mailing address
11700 ALPINE HWY, FRAZEYSBURG, OH 43822-9382
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
03914
OH
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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