Individual
MRS. TABATHA DANIELLE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1036 S MAIN ST, HAMBURG, AR 71646-8980
(870) 853-0857
Mailing address
244 DEAN CHURCH RD, MARION, LA 71260-4222
(318) 292-5250
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A468
AR
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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