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Individual

KIMI MARIE KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
2661 S BROADWAY, GREEN BAY, WI 54304-5305
(920) 592-5262
Mailing address
2757 NICOLET DR, GREEN BAY, WI 54311-7219
(920) 391-1565

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
383026
WI
225X00000X
Occupational Therapist
838-26
WI

Other

Enumeration date
01/31/2008
Last updated
10/30/2024
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