Kellie J Mulligan
Occupational Therapist in Tampa, FL. Individual provider (NPI-1).
NPI number1982240750
StatusActive
Last updated in NPPESNov 26, 2019
Details
- NPI
- 1982240750
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kellie J Mulligan
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 26, 2019
- Last updated
- Nov 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | 10788 | FL | Yes |
Practice location
17470 Brookside Trace CtTampa, FL 33647-6201
Phone 813-600-5994
Mailing address
10276 Estuary DrTampa, FL 33647-3123
Phone 813-994-5911
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