Individual
ANNIE M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
813 FAY RD, SYRACUSE, NY 13219-3009
(315) 488-2951
Mailing address
103 FERNDALE RD, SYRACUSE, NY 13219-2337
(315) 488-2951
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
013951
NY
Other
Enumeration date
05/12/2006
Last updated
09/03/2008
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