Individual
KELLIE TYSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
334 BAR HARBOR ROAD, PASADENA, MD 21122
(410) 218-3215
Mailing address
334 BAR HARBOR ROAD, PASADENA, MD 21122
(410) 218-3215
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
03101
MD
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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