Individual
JENNIFER KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 GAINSBORO RD, BALA CYNWYD, PA 19004-2014
(215) 421-2104
Mailing address
1215 GAINSBORO RD, BALA CYNWYD, PA 19004-2014
(215) 421-2104
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP001860L
PA
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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