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General NPI Number Information
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NPI Number | 1407669229
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Entity Type | Individual
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Provider Name | KELLY MORAN
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Gender | Female
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 455 POST RD STE 202
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City | DARIEN
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State | CT
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Zip | 06820-3670
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Country | US
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Telephone | 203-424-2584
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Fax |
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Provider Business Mailing Address
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Address Line | 46 1ST ST FL 2
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City | NORWALK
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State | CT
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Zip | 06855-2320
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Country | US
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Telephone | 603-686-4108
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 6510
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License Number State | CT
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