Individual
KELSY WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
620 SAND HILL RD, PALO ALTO, CA 94304-2002
(888) 926-1850
Mailing address
1125 PARK PL APT 122, SAN MATEO, CA 94403-1578
(650) 392-5552
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
22827
CA
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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