Individual
KEELIN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2927 S FISH HATCHERY RD, FITCHBURG, WI 53711-6498
(608) 819-6393
Mailing address
3083 VILAS RD, COTTAGE GROVE, WI 53527-9492
(608) 575-6286
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5476-27
WI
224Z00000X
Occupational Therapy Assistant
OTP-OTA-LIC-4668
MT
Other
Enumeration date
11/16/2016
Last updated
03/21/2018
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