Individual
MRS. KELLIE J MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17470 BROOKSIDE TRACE CT, TAMPA, FL 33647-6201
(813) 600-5994
Mailing address
10276 ESTUARY DR, TAMPA, FL 33647-3123
(813) 994-5911
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10788
FL
Other
Enumeration date
11/26/2019
Last updated
11/26/2019
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