Individual
KELLY STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
250 E DAY RD, MISHAWAKA, IN 46545-3471
(574) 247-8700
Mailing address
250 E DAY RD, MISHAWAKA, IN 46545-3471
(574) 247-8700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31000907A
IN
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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