Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | Z11062 | LA |
N | 225XH1200X | Occupational Therapist - Hand | Z110662 | LA |
NPI | 1043255011 |
---|---|
Provider Name | Kelly N Key |
First Address | Shreveport, LA 71103-3934 |
Second Address | Bossier City, LA 71111-2167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 08/07/2007 |