Individual
KELSEY ORIELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
7162 LONE OAK WAY, LITHONIA, GA 30058-8291
(770) 990-0928
Mailing address
7162 LONE OAK WAY, LITHONIA, GA 30058-8291
(770) 990-0928
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007460
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT007460
GA STATE LICENSE
GA
Enumeration date
08/06/2019
Last updated
08/06/2019
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