Individual
MRS. KELLIE S DOOLITTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
980 MONTGOMERY ST, MANDEVILLE, LA 70448-5519
(434) 987-3396
Mailing address
980 MONTGOMERY ST, MANDEVILLE, LA 70448-5519
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
200095
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-2541563
TAX ID ADVANCE HAND SPECIALIST DBA MCMILLIAN CORPORTAION
LA
01
—
27-1727146
TAXPAYER IDENITIFICATION NUMBER MCMILLIAN CORPORATION
LA
Enumeration date
06/29/2007
Last updated
08/09/2013
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