Individual
KELLE MALKEWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
2854 HIGHLAND GRAY RD, POULTNEY, VT 05764-9124
(802) 287-9610
Mailing address
2854 HIGHLAND GRAY RD, POULTNEY, VT 05764-9124
(802) 287-9610
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
23309
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23309
NATIONAL COUNCIL FOR THERAPEUTIC RECREATION CERTIFICATION
—
Enumeration date
04/09/2022
Last updated
04/09/2022
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