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Individual

MRS. KELLY YOUNG PARTAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR,L

Contact information

Practice address
37937 HEATHER PL, DADE CITY, FL 33525-5420
(813) 714-5815
(813) 779-1879
Mailing address
37937 HEATHER PL, DADE CITY, FL 33525-5420
(813) 714-5815
(813) 779-1879

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 6031
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019442800
FL
01
Z9537
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/20/2006
Last updated
10/01/2025
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