Individual
BREANNA JEAN KELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1290 CELEBRATION BLVD, KISSIMMEE, FL 34747-4692
(321) 337-7400
Mailing address
3730 DALE ST, LAKELAND, FL 33812-4118
(863) 308-1744
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16845
FL
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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