Individual
KELLY JANE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, OTR/L
Contact information
Practice address
1581 DODD DR, COLUMBUS, OH 43210-1257
(614) 685-6701
Mailing address
1581 DODD DR, COLUMBUS, OH 43210-1257
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT.008041
OH
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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