| NPI | 1750905147 |
|---|---|
| Former Name | KELLI FOWLER |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2021-06-01 |