Individual
MISS KELSI ALEXIS SHOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1755 WITTINGTON PL, STE 800, DALLAS, TX 75234-1927
(866) 221-5405
Mailing address
2145 NORTHGLEN DR, CLOVIS, NM 88101-9357
(806) 787-3022
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1761
NE
225X00000X
Occupational Therapist
Primary
3243
NM
Other
Enumeration date
01/16/2014
Last updated
01/24/2018
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