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Individual

KELLY TALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
2706 NE INDEPENDENCE AVE, LEES SUMMIT, MO 64064-2323
(816) 446-9018
(816) 554-1379
Mailing address
2412 SW RIVER TRAIL RD, LEES SUMMIT, MO 64082-7811
(816) 446-9018
(816) 554-1379

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2019005336
MO

Other

Enumeration date
03/03/2019
Last updated
01/15/2024
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