Individual
MRS. KELLY HINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
275 PARRISH ST, CANANDAIGUA, NY 14424-1785
(585) 393-0554
Mailing address
8240 HONEYSUCKLE DR, LIVERPOOL, NY 13090-6839
(315) 751-1510
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6072751
NY
Other
Enumeration date
01/08/2010
Last updated
01/08/2010
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