Individual
MOLLY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2018 MCINGVALE RD STE 102, HERNANDO, MS 38632-8706
(662) 298-2276
(662) 298-2278
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-4089
MS
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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