Individual
STACEY KELSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
585 SAINT AUGUSTINE DR, SUMTER, SC 29150-6008
(614) 477-9214
(855) 232-8604
Mailing address
585 SAINT AUGUSTINE DR, SUMTER, SC 29150-6008
(614) 477-9214
(855) 232-8604
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5270
SC
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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