Individual
KELLY LYNN SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
307 W 38TH ST RM 1305, NEW YORK, NY 10018-9521
(212) 943-1404
Mailing address
3240 OLD BETHLEHEM PIKE, COOPERSBURG, PA 18036-2808
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TOP009133
PA
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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