Individual
MRS. KELLY BOENIG D'AQUILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
4794 REED STREET, SAINT FRANCISVILLE, LA 70775-0276
(225) 635-0149
Mailing address
PO BOX 276, 4794 REED STREET, SAINT FRANCISVILLE, LA 70775-0276
(225) 635-0149
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z12040
LA
Other
Enumeration date
05/31/2007
Last updated
05/08/2014
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