Individual
MRS. KELLI D NITSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
306 E 11TH ST, RUSSELLVILLE, AR 72801-6156
(479) 968-1198
(479) 967-1178
Mailing address
4707 DEXTER AVE, FORT WORTH, TX 76107-3737
(479) 857-6637
(479) 967-1178
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
O-T1039
AR
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
08/13/2010
Last updated
07/13/2021
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