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Individual

KELLY SUE DIFFIN BALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
114 BARBARA ST, CADILLAC, MI 49601-2446
(231) 775-1851
Mailing address
114 BARBARA ST, CADILLAC, MI 49601-2446
(231) 775-1851

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202006887
MI

Other

Enumeration date
06/28/2014
Last updated
06/28/2014
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