Individual
KELLY KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 SAGUARO TRL, SAN JUAN COLLEGE OTA PROGRAM, FARMINGTON, NM 87401-9632
(505) 598-6000
Mailing address
800 SAGUARO TRL, SAN JUAN COLLEGE OTA PROGRAM, FARMINGTON, NM 87401-9632
(505) 598-6000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2526
NM
Other
Enumeration date
12/15/2015
Last updated
12/15/2015
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