| NPI | 1750615407 |
|---|---|
| Former Name | KELLY DURCHOLZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics (Licence: TN 3992) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AR OTR2517) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2012-08-16 |