Individual
KELSIE WILSON WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
26420 KENSINGTON PL STE C, DAPHNE, AL 36526-5123
(251) 517-0355
(251) 625-1969
Mailing address
9916 WINDMILL RD APT 11, FAIRHOPE, AL 36532-3717
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3678
AL
Other
Enumeration date
10/31/2013
Last updated
10/31/2013
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