Individual
MRS. REBECCA L KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
160 DEER RUN DR, FALL RIVER, WI 53932-8934
(920) 484-3230
Mailing address
160 DEER RUN DR, FALL RIVER, WI 53932-8934
(920) 484-3230
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1638-027
WI
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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