Kelly, Mary Jo
Kelly, Mary Jo is an individual health care provider with primary practice located at 1191 Bellamy Tipton Rd , Gate City VA 24251-5046. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Kelly, Mary Jo can be contacted via phone (239) 292-7489.Contact Information
Primary practice address
1191 Bellamy Tipton Rd
Gate City VA 24251-5046
Phone: (239) 292-7489
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 5809 | Florida |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Rehabilitation | 225XP0019X | OT0000004939 | Tennessee |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OT0000004939 | Tennessee |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 0119007492 | Virginia |
Profile Details
| NPI number | 1578068185 |
|---|---|
| LBN Legal business name | Kelly, Mary Jo |
| Credentials | OTR/L |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 26th, 2018 |
| Last updated | May 22nd, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578068185 | NPPES |
| Virginia | Other | 0119007492 | STATE OT LICENSE |
| Virginia | Other | 134421797 | STATE OT LICENSE |
| Virginia | Other | OT0000004939 | STATE OT LICENSE |
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