Individual
KELSEY THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
425 WILLIAMS DR, 113, MARIETTA, GA 30066-6157
(404) 561-4552
Mailing address
425 WILLIAMS DR, 113, MARIETTA, GA 30066-6157
(404) 561-4552
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OT 005074
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT 005075
GA OT LICENSE
GA
Enumeration date
06/23/2015
Last updated
07/22/2021
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