Individual
KELLENE ISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
612 MAGNOLIA AVE, SUITE A, AUBURNDALE, FL 33823-4108
(863) 412-8080
Mailing address
870 REDWOOD WAY, LAKE WALES, FL 33898-9130
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT11428
FL
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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