Provider Demographics
NPI:1184038010
Name:CABRERA, KELLI ANNE (MS, OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:ANNE
Last Name:CABRERA
Suffix:
Gender:F
Credentials:MS, OTR/L, CHT
Other - Prefix:MS
Other - First Name:KELLI
Other - Middle Name:ANNE
Other - Last Name:LARAMEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L, CHT
Mailing Address - Street 1:1516 HIGHWAY 138
Mailing Address - Street 2:SUITE C
Mailing Address - City:WALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07719
Mailing Address - Country:US
Mailing Address - Phone:702-653-3100
Mailing Address - Fax:
Practice Address - Street 1:12350 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223
Practice Address - Country:US
Practice Address - Phone:904-661-4400
Practice Address - Fax:904-240-4472
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11097225X00000X
FLOT19433225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist