Individual
KELLY O'BRIEN LILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4650 MCMASTERS AVE, HANNIBAL, MO 63401-2244
(673) 221-1258
Mailing address
2645 HIGHWAY A, PALMYRA, MO 63461-2040
(573) 231-1403
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2011001376
MO
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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