| NPI | 1902205313 |
|---|---|
| Former Name | KELLY GRACE PARKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: FL OT 15182) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AL 3580) |
| 225X00000X Occupational Therapist (Licence: FL OT15182) | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2022-02-03 |