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General NPI Number Information
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NPI Number | 1962758227
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Entity Type | Individual
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Provider Name | KELLY LOUVIERE OT/R
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Gender | Female
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Dates
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Enumeration Date | 07/24/2012
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 3312 NW WILLOW CREEK DRIVE
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City | JENSEN BEACH
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State | FL
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Zip | 34957-3044
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Country | US
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Telephone | 321-289-9955
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Fax |
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Provider Business Mailing Address
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Address Line | 3312 NW WILLOW CREEK DRIVE
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City | JENSEN BEACH
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State | FL
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Zip | 34957
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Country | US
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Telephone | 321-289-9955
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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 | 19674
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License Number State | FL
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