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 |