KELLY LEE GRANT

FORT WAYNE, IN
NPI1053871368
Former NameKELLY LEE PIEPENBRINK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: IN  31007250A)
Additional Taxonomies106S00000X Behavior Technician
(Licence: IN  RBT-17-44326)
Enumeration Date2019-03-22
Last Update Date2023-11-14
Business Address
KELLY LEE GRANT OTR
3320 N CLINTON ST
FORT WAYNE, IN 46805-1918
Phone number: 260-483-2100
Mailing Address
KELLY LEE GRANT OTR
3320 N CLINTON ST
FORT WAYNE, IN 46805-1918
Phone number: