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Individual

KELLY TYLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3760 CONVOY ST STE 204, SAN DIEGO, CA 92111-3744
(858) 514-0375
Mailing address
1086 QUAIL GARDENS CT, ENCINITAS, CA 92024-2782

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17193
CA

Other

Enumeration date
03/17/2017
Last updated
03/17/2017
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