Individual
KELLY WHITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28515 N NORTH VALLEY PKWY, APT 1096, PHOENIX, AZ 85085-5401
(623) 313-3469
Mailing address
28515 N NORTH VALLEY PKWY, APT 1096, PHOENIX, AZ 85085-5401
(623) 313-3469
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6709
AZ
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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