Individual
BREANNE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
927 BROADWAY ST STE 100, QUINCY, IL 62301-2728
(217) 222-9300
Mailing address
927 BROADWAY ST STE 100, QUINCY, IL 62301-2728
(217) 222-9300
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056013640
IL
Other
Enumeration date
06/02/2020
Last updated
05/05/2023
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