Individual
KAYLYN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6717450-4201
UT
Other
Enumeration date
07/16/2013
Last updated
01/23/2019
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