Individual
KELSEY HAVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
939 DREXEL AVE, JOHNSTOWN, PA 15905-2118
(412) 352-6315
Mailing address
939 DREXEL AVE, JOHNSTOWN, PA 15905-2118
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP007227
PA
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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