Provider Demographics
NPI:1629821061
Name:TURNER, KELLY (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 TEASDALE LN APT 108
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3799
Mailing Address - Country:US
Mailing Address - Phone:336-906-3246
Mailing Address - Fax:
Practice Address - Street 1:1321 E SUNSET DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-4324
Practice Address - Country:US
Practice Address - Phone:704-248-6974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15307225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist