Individual
KELLY DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
3461 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4302
(215) 823-4507
Mailing address
2701 W GIRARD AVE APT 6, PHILADELPHIA, PA 19130-1251
(412) 715-8316
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
PA
Other
Enumeration date
02/27/2023
Last updated
05/16/2023
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