Individual
MRS. KELLY SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
235 MYRTLE ST, MANCHESTER, NH 03104-4314
(603) 627-3811
Mailing address
76 NEW LONDON DR, WEBSTER, NH 03303-7921
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0767
NH
Other
Enumeration date
08/30/2017
Last updated
08/30/2017
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