Individual
MRS. ANGELA DENISE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
50 VIOLET CT, LONDON, KY 40741
(606) 877-1255
Mailing address
200 TOWER CIR, SOMERSET, KY 42503-3480
(606) 416-5139
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
R1147
KY
225X00000X
Occupational Therapist
Primary
134172
KY
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
01/10/2008
Last updated
06/06/2018
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