Individual
JENNIFER JO KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
803 STUBBS AVE STE D, MONROE, LA 71201
(318) 388-8414
(318) 388-8558
Mailing address
803 STUBBS AVE STE D, MONROE, LA 71201
(318) 388-8414
(318) 388-8558
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT212140
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1318426
—
LA
Enumeration date
01/29/2007
Last updated
07/08/2007
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