Provider Demographics
NPI:1851310163
Name:KELLEY, HELEN M (OTR/L)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:M
Last Name:KELLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 E MOUNTAIN ST
Mailing Address - Street 2:BUILDING 318, SUITE 101
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7997
Mailing Address - Country:US
Mailing Address - Phone:336-996-4980
Mailing Address - Fax:336-996-3521
Practice Address - Street 1:1031 E MOUNTAIN ST
Practice Address - Street 2:BUILDING 318, SUITE 101
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7997
Practice Address - Country:US
Practice Address - Phone:336-996-4980
Practice Address - Fax:336-996-3521
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5160225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist