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General NPI Number Information
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NPI Number | 1376367714
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Entity Type | Individual
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Provider Name | KELLEE MARIE O'MELIA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 36 FIRETOWN RD
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City | SIMSBURY
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State | CT
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Zip | 06070-3401
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Country | US
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Telephone | 860-658-1018
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Fax |
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Provider Business Mailing Address
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Address Line | 314 KIBBE RD
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-1311
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Country | US
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Telephone | 413-426-3782
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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 | 004267
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License Number State | CT
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