| NPI | 1003034331 |
|---|---|
| Other Name | KELLY ELIZABETH PROCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: SC 2713) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: SC 2713) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2023-07-31 |