| NPI | 1104053529 |
|---|---|
| Former Name | KELLY ANN RUSSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: LA OTT.Z1156) |
| Additional Taxonomies | 225XE0001X Occupational Therapist Environmental Modification (Licence: LA OTT.Z1156) |
| 225XF0002X Occupational Therapist Feeding, Eating & Swallowing (Licence: LA OTT.Z1156) | |
| 225XM0800X Occupational Therapist Mental Health (Licence: LA OTT.Z1156) | |
| 225XN1300X Occupational Therapist Neurorehabilitation (Licence: LA OTT.Z1156) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2023-06-20 |