Individual
KELLY SALAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
701 DEMING WAY STE 110, MADISON, WI 53717-2916
(608) 819-6394
Mailing address
902 W BADGER RD APT 8, MADISON, WI 53713-2448
(715) 220-2670
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5650-27
WI
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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