Individual
KELLY ANNE STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Contact information
Practice address
851 PROFESSIONAL PARK DR, CLARKSVILLE, TN 37040-5257
(931) 542-2168
(615) 619-2388
Mailing address
1269 GENTRY DR, CLARKSVILLE, TN 37043-1639
(636) 328-7787
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7039
TN
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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