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Individual

KELLY PACHECO AMARAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
626 PARK AVE STE 2A, CRANSTON, RI 02910-2154
(401) 270-9991
Mailing address
626 PARK AVE STE 2A, CRANSTON, RI 02910-2154

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT01904
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0163744043
RI
Enumeration date
09/10/2020
Last updated
03/28/2022
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