Individual
KELLY EVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
333 E 2ND ST, RICHLAND CENTER, WI 53581-1914
(608) 647-6321
Mailing address
333 E 2ND ST, RICHLAND CENTER, WI 53581-1914
(630) 699-8683
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056014932
IL
225X00000X
Occupational Therapist
123612
TX
225X00000X
Occupational Therapist
Primary
7147
WI
225X00000X
Occupational Therapist
OT23926
FL
225X00000X
Occupational Therapist
OTH-009315
AZ
Other
Enumeration date
03/29/2024
Last updated
03/29/2024
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