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General NPI Number Information
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NPI Number | 1801125059
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Entity Type | Individual
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Provider Name | KELLI ANDRESS O.T.
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Gender | Female
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Dates
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Enumeration Date | 12/17/2009
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Last Update Date | 12/17/2009
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Provider Practice Location Address
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Address Line | 403 2ND AVE STE 101
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City | OPELIKA
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State | AL
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Zip | 36801-4382
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Country | US
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Telephone | 334-741-4041
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Fax |
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Provider Business Mailing Address
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Address Line | 789 LEE ROAD 370
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City | VALLEY
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State | AL
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Zip | 36854-6440
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Country | US
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Telephone | 334-444-2282
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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 | 1973
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License Number State | AL
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