Most Relevant Information
Provider Data
| NPI Number: | 1003249046 |
| Provider Name: | KELLY JEAN SQUIRE-HAMBLET MSOTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 13-0346 |
Most Important Dates
| Enumeration Date: | 08/13/2013 |
| Last Updated: | 08/13/2013 |
Provider Practice Location
5540 AZUZA AVE
LAS VEGAS
NV
891227121
Practice Location Phone/Fax
| Phone: | 7023489076 |
| Fax: |
Provider Mailing Location
5540 AZUZA AVE
LAS VEGAS
NV
891227121
Provider Mailing Phone/Fax
| Phone: | 7023489076 |
| Fax: |