Individual
HAZLEY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2012 S JONES BLVD, LAS VEGAS, NV 89146-3151
(702) 360-1137
Mailing address
2012 S JONES BLVD, LAS VEGAS, NV 89146-3151
(702) 360-1137
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-2023-0233
NM
225X00000X
Occupational Therapist
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
11/06/2019
Last updated
10/12/2023
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