Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0845 | NH |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 0845 | NH |
NPI | 1710146378 |
---|---|
Provider Name | Cynthia Louise Kelly |
First Address | Londonderry, NH 03053-3321 |
Second Address | Nashua, NH 03062-2145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2008 |
Last Update Date | 08/06/2008 |