Individual
KELSEY KATHLEEN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
1321 CEDAR LN, TULLAHOMA, TN 37388-2227
(931) 222-4207
Mailing address
1321 CEDAR LN, TULLAHOMA, TN 37388-2227
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5742
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5742
TN STATE BOARD
TN
Enumeration date
12/31/2017
Last updated
12/31/2017
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