Individual
KELLY ANN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
161 SE 5TH CT, POMPANO BEACH, FL 33060-7164
(661) 319-1591
Mailing address
161 SE 5TH CT, POMPANO BEACH, FL 33060-7164
(661) 319-1591
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT11525
FL
225XG0600X
Gerontology Occupational Therapist
OT11525
FL
225XL0004X
Low Vision Occupational Therapist
OT11525
FL
225XN1300X
Neurorehabilitation Occupational Therapist
OT11525
FL
225XP0019X
Physical Rehabilitation Occupational Therapist
OT11525
FL
Other
Enumeration date
05/08/2008
Last updated
11/20/2019
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