Kelly A Williams Wyche, OTR/L
Specialist in Raleigh, NC. Individual provider (NPI-1).
NPI number1174729263
StatusActive
Last updated in NPPESJul 2, 2014
Details
- NPI
- 1174729263
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kelly A Williams Wyche
- Credential
- OTR/L
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 25, 2007
- Last updated
- Jul 2, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 116166 | TX | Yes |
| 225X00000X | Occupational Therapist | 4537 | NC |
Practice location
3001 Spring Forest RdRaleigh, NC 27616-2815
Phone 919-424-5080
Mailing address
541 Valley View DrLewisville, TX 75067-7772
Phone 919-920-4506
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