Individual
KELLY ELLEN PESTEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
42 PROSPECT ST, MANCHESTER, CT 06040-5802
(860) 645-1255
Mailing address
695 TOBACCO ST, LEBANON, CT 06249-1632
(860) 608-6674
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
002122
CT
Other
Enumeration date
11/27/2021
Last updated
11/27/2021
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