Individual
JACQUELINE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-0111
Mailing address
39 FARM GATE RD, FALMOUTH, ME 04105-1286
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4615
ME
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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