Individual
MS. KELLEY O'BRIEN HUTCHISON-MARAVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1300 EGG HARBOR RD, SUITE 108, STURGEON BAY, WI 54235
(920) 746-0410
Mailing address
1300 EGG HARBOR RD., SUITE 108, STURGEON BAY, WI 54235
(920) 746-0410
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2678-26
WI
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40785700
—
WI
Enumeration date
08/25/2006
Last updated
02/26/2010
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