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General NPI Number Information
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NPI Number | 1245315985
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Entity Type | Individual
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Provider Name | NANCY JEAN KELLY OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 75 FRANCIS ST
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City | BOSTON
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State | MA
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Zip | 02115-6110
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Country | US
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Telephone | 617-732-5301
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Fax |
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Provider Business Mailing Address
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Address Line | 275 WOOD ST
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City | LEXINGTON
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State | MA
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Zip | 02421-6425
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Country | US
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Telephone | 781-861-9095
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1400
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License Number State | MA
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