Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 244484 | OR |
NPI | 1376788141 |
---|---|
Provider Name | Erin C Kell |
First Address | Medford, OR 97504-6505 |
Second Address | Medford, OR 97504-6505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2008 |
Last Update Date | 09/12/2008 |