Individual
KELLEY BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2751
AR
225X00000X
Occupational Therapist
Primary
OTR3065
AR
Other
Enumeration date
07/26/2013
Last updated
08/27/2024
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