| Doctor Name: | MS. KELLY ELIZABETH WALSH |
| NPI Number: | 1629285689 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, ATC, LAT, PES |
| License Number: | AH1421-AT |
| Business Practice Address: | University Of California Santa Barbara Department Of Intercollegiate Athletics, Ica Building Santa Barbara, CA - 931065200 |
| Business Phone Number: | 8058933424 |
| Business Fax Number: | 8058935420 |
| Mailing Address: | 4025 E. Skelton Canyon Cir., WESTLAKE VILLAGE |
| State: | CA |
| Postal Code: | 913624232 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/17/2007 |
| NPI Last Update Date: | 08/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | AH1421-AT |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |