Provider Demographics
NPI:1851925515
Name:MAGUIRE, KELLY LEE (OTR/L, CWLT)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:LEE
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:OTR/L, CWLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2856
Mailing Address - Country:US
Mailing Address - Phone:508-366-7031
Mailing Address - Fax:
Practice Address - Street 1:287 TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2856
Practice Address - Country:US
Practice Address - Phone:508-366-7031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9744225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist