Individual
KELLYANN PATRICIA ELSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DOTR/L
Contact information
Practice address
12 MARLBOROUGH AVE, MARLTON, NJ 08053-2917
(856) 472-4707
Mailing address
12 MARLBOROUGH AVE, MARLTON, NJ 08053-2917
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
117875
TX
225X00000X
Occupational Therapist
Primary
46TR01126700
NJ
Other
Enumeration date
02/19/2019
Last updated
08/12/2024
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