Individual
KELLY ELIZABETH SILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1351 W PINE AVE, MERIDIAN, ID 83642-5031
(208) 888-7049
Mailing address
9 ALEJO, IRVINE, CA 92612-2913
(949) 394-0054
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1481
ID
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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