Individual
MS. KELLY A. CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.T.
Contact information
Practice address
1131 MAPLE LN, BATAVIA, IL 60510-1185
(630) 879-6231
Mailing address
1131 MAPLE LN, BATAVIA, IL 60510-1185
(630) 879-6231
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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